Continuous Glucose Monitoring Could Improve Outcomes in Pediatric Patients With Leukemia/Lymphoma
A pilot study presented at the American Diabetes Association 84th Scientific Sessions showed that CGM technology could produce reliable results without complications in children with leukemia/lymphoma at risk for hyperglycemia.
Blinded continuous glucose monitoring (CGM) technology worn during induction therapy may provide reliable results without complications to pediatric patients with leukemia/lymphoma (ALL/LLy), according to a study abstract presented at the American Diabetes Association 84th Scientific Sessions, held June 21 to 24 in Orlando, Florida.1
CGM on child's arm / habrovich - stock.adobe.com
During initial treatment in children with ALL/LLy, hyperglycemia can lead to increased monitoring needs, additional medical interventions, and longer hospital stays. Addressing this, investigators studied whether the use of a CGM in the patient population could reduce complications associated with high blood sugar.
The study, conducted at Children’s Healthcare of Atlanta, began in February 2022 and is ongoing. Children with ALL/LLy between the ages of 1 and 21 are enrolled. Following participation in a parent study measuring hyperglycemia risk, participants are invited to join a blinded CGM arm.
READ MORE: Examining GLP-1 Trends in T2D, Risk of Obesity-Related Malignancies
Among 53 patients who completed initial treatment in the parent study as of December 2023, all experienced hyperglycemia. Most (77%) had grade 1 hyperglycemia, and the rest (23%) had grade 2 or higher. Those who had grade 2 or hyper were more likely to have a family history of diabetes, and insulin management was required for patients who had grade 3 hyperglycemia.
Nine patients used a CGM, wearing it for an average of 77% of the active monitoring period. Six patients wore it for over 70% of the time. The CGM was used in nearly half (44%) of patients in the CGM arm, compared to only 2% in the non-CGM arm. No skin rash or infection occurred at the CGM site for any participants.
Although the pilot study showed that CGM technology could produce reliable results without complications, investigators noted that “additional studies are needed to explore expanded use of CGM in similar patient populations.” This is especially important considering the rise in diabetes prevalence in young people. The CDC estimates that by 2060, 526,000 young people will have either type 1 or type 2 diabetes, compared to 213,000 diagnoses in 2017.2
CGM offers several advantages for patients with cancer. Common treatments, such as chemotherapy, administration of steroids, and artificial nutrition can cause wide variability in blood sugar levels.3 Uncontrolled, these fluctuations can worsen outcomes and raise infection risks. By providing real-time blood sugar data, CGM can allow for proactive adjustments in medication or diet to maintain healthy glucose levels. What’s more, CGMs can allow better glucose management for patients who are asymptomatic.
CGMs eliminate the need for finger pricks, as well, which provides further benefit to certain patient subpopulations. Whereas finger pricks can be extremely painful for patients with chemotherapy-related neuropathy or cause prolonged bleeding times and bruising in patients with thrombocytopenia, CGMs require less sticks.
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READ MORE: Continuous Glucose Monitoring Resource Center
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