Endocrine Abstracts

Introduction: Childhood obesity is associated with complications, such as type 2 diabetes mellitus (T2DM). The use of continuous glucose monitoring (CGM) in diabetes mellitus is well established, but there is limited research evaluating the role of CGM in childhood obesity. The aim of this study was to investigate the use of CGM in identifying glycaemic dysregulation in children and young people (CYP) with obesity and the effect of lifestyle therapy.

Methods: 32 patients were recruited onto the prospective study (PD-LOOP), with 29 completing the 3-month lifestyle intervention. Anthropometric measurements, body composition data, oral glucose tolerance test (OGTT), blinded CGM (Dexcom G6) and PedsQL 4.0 generic scale questionnaire were completed at baseline and 3-months. During the 3-months, participants and their caregivers received two weekly inputs for lifestyle modification.

Results: The mean age was 14.0 years (10.1 to 16.7) with 51.7% (15/29) being female. The mean body mass index at baseline was 44.3kg/m2 (+3.74 SDS). Over the 3-months, there was no significant change in measurements or body composition. One patient progressed to impaired glucose tolerance at 3-months. The CGM was worn for an average of 8 days and showed a mean glucose of 6.4 mmol/L at baseline and 6.6 mmol/L at 3-months. The readings showed a reduction in the time that the glucose levels spent within the normal range, despite regular input for lifestyle modification. The median time within normal range (86% at baseline and 83% at 3-months) was much less than that reported in CYP without diabetes and obesity (97%). The median time spent with glucose levels over 10 mmol/L was 1% at both time-points, which was 0% in the comparison data.

Conclusion: The study has highlighted the limitations of lifestyle intervention in improving glycaemic dysregulation in CYP with severe obesity. The pilot data shows the potential of CGM in identifying glycaemic dysregulation, despite the normal OGTT results, and the potential to use CGM in monitoring the glycaemic response to therapy in CYP without diabetes mellitus. Recognising the glucose abnormalities early is crucial in developing targeted interventions to reduce the risk of progression to T2DM.