Glycemic Analysis and Stratification of Pediatric Patients with Type 1 Diabetes Using isCGM in Southern Spain: Insights from the Andiacare Digital Platform
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background/Objectives: Type 1 diabetes mellitus (T1D) is the most common metabolic disorder in children, with significant physical and emotional impacts. Achieving optimal glucometric control is challenging due to the complex management and limitations of insulin therapy. Advances in pharmacology and technology, including continuous glucose monitoring (CGM) systems, offer new options for diabetes management. We developed Andiacare, an open-source platform for macro/micro-management of diabetes and analyzed its application in a pediatric T1D cohort to evaluate glucometric control patterns. Methods: A retrospective cohort study was conducted in a pediatric population (<18 years old) in Andalusia, Spain. Patients treated with Multiple Daily Injections of Insulin (MDI) and FreeStyle Libre 2 System (Abbott, Spain) were included. The patient data were analyzed using the Andiacare platform, which categorizes patients based on the Advanced Technologies and Treatments for Diabetes (ATTD) panel’s targets for glucometric control. Results: The study included 2215 patients from 18 pediatric hospitals. The Andiacare platform categorized patients into four groups based on glucometric control parameters, enabling patient stratification based on their glucometric control. Only 25.8% of the cohort achieved the recommended Time in Range (TIR), and 9.5% of the patients achieved all target parameters of glucometric control. Age is a determinant factor in adherence and achievement of set goals. Conclusions: This study offers insights into glucometric control in a large pediatric population with T1D in Andalusia. Few patients achieved the recommended glucometric control targets, highlighting the need for improved management strategies. The use of digital platforms such as Andiacare might contribute to facilitating the management of large pediatric cohorts. New algorithms integrating glucometric and non-glucometric parameters are required for improved individual and cohort categorization to optimize therapeutic interventions.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm14176243
Authors: Isabel Leiva-Gea, Fernando Moreno-Jabato, Ana Belén Ariza-Jiménez, Alfonso Lendínez-Jurado, Ana Gómez-Perea, María del Mar Romero-Pérez, Emilio García-García, María Ángeles Santos Mata, Gabriela Martínez-Moya, Jerónimo Momblan, Alfonso María Lechuga-Sancho, José María Gómez-Vida, Mercedes Mier-Palacios, María del Pilar Ranchal-Pérez, Gustavo Vivas-González, Patricia Calleja Cabeza, Eugenio Fernández-Hernández, Ana Pilar Jiménez-Martín, Jessica Guarino-Narváez, Pablo Rodríguez de Vera-Gómez, María Asunción Martínez-Brocca
Institutions: Hospital Regional Universitario de Málaga, Andalusian Centre for Nanomedicine and Biotechnology, Instituto de Investigación Biomédica de Málaga, Universidad Europea de Andalucía, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, University of Córdoba, Hospital Universitario Virgen Macarena, Hospital Universitario Virgen del Rocío, Hospital Universitario de Jerez, Complejo Hospitalario Torrecárdenas, Universidad de Cádiz, Biomedical Research and Innovation Institute of Cadiz, Hospital Universitario Puerta del Mar, Hospital Juan Ramón Jiménez, Hospital Costa del Sol, Hospital Alto Guadalquivir, Instituto Hispalense de Pediatria, Hospital Infanta Margarita
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
Funder: Junta de Andalucía
OpenAlex ID: W4413991422
