Bridging the Gap: Adoption and Barriers to Continuous Glucose Monitoring in Paediatric Type 1 Diabetes
https://doi.org/10.15605/jafes.041.S1
- Author:
Sok Bee Lim
1
;
Siti Sarah Ahmad Dardiri
1
;
Nalini M. Selveindran
1
;
Arini Nuran Md Idris
1
;
Janet Yeow Hua Hong
1
Author Information
1. Paediatric Endocrine Unit, Hospital Putrajaya
- Publication Type:Journal Article
- MeSH:
Child;
Blood Glucose;
Blood Glucose Self-Monitoring;
Continuous Glucose Monitoring;
Diabetes Mellitus, Type 1
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):123-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:ISPAD guidelines recommend continuous glucose monitoring (CGM) as the standard of care for paediatric type 1 diabetes
(T1DM). However, a “real-world” adoption gap persists, particularly in resource-limited settings. The Introductions of
the study were to evaluate CGM adoption prevalence, identify documented barriers, and compare glycemic outcomes
between active and non-active users.
Methodology:This retrospective review analyzed electronic medical records (EMR) of 125 paediatric T1DM patients at Hospital Putrajaya
(2025). Data included CGM status, insulin delivery method, and documented barriers. Independent T-tests compared
mean hemoglobin A1c (HbA1c) between groups, and multivariable logistic regression identified independent predictors
of adoption.
Results:Cohort mean age was 11.8 ± 3.8 years. Active CGM users were 32.8% (n = 41), of whom 29.3% (n = 12) utilized predominantly
automated insulin delivery (AID) systems. The remaining 67.2% (n = 84) were classified as non-active users, comprising
both never-users and ex-users (discontinued use). Active users achieved significantly lower mean HbA1c than non-active
users (8.73% vs 9.86%; p <0.001), with no significant difference in rates of DKA (p = 0.564) or severe hypoglycemia (p =
0.250). Among never-users, 42.9% lacked documented technology counselling (p = 0.001). Multivariable analysis identified
funding source as the sole independent predictor of CGM adoption (adjusted OR = 7.76, p <0.001). While the primary
documented barrier was financial (31.0%), a lack of documented barriers was noted in 61.9% of non-active users.
Conclusion:A substantial technology gap exists, primarily driven by financial access rather than clinical demographics. The difference
of 1.13% in HbA1c between groups underscores the need to address financial setbacks to improve technology access in
Malaysia and prevent diabetes complications.
- Full text:2026080510092494247OP_P001.pdf
