GSB 7.1 Standardlösung

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Diabetes in Germany - children and adolescents

Continuous glucose monitoring

Continuous glucose monitoring (CGM) is a minimally invasive method of measuring sugar levels in the interstitial fluid of the subcutaneous tissue. A glucose sensor is used to take either continuous (real-time CGM systems; rtCGM) or intermittent (flash glucose monitoring, FGM, intermittent glucose monitoring; iscCGM) measures that are then transmitted to a receiving device. CGM makes it possible to measure sugar levels without the need for blood samples and is particularly useful for children and adolescents with type 1 diabetes (AGPD 2015, DDG 2018). Since 2016, the costs of CGM devices have been covered by statutory health insurers (G-BA 2016).

Key messages

  • Almost 95% of children and adolescents with type 1 diabetes in Germany use continuous glucose monitoring.
  • No differences were identified between the sexes in the use of continuous glucose monitoring.
  • The reimbursement of costs by statutory health insurers and the availability of new, user-friendly devices have played a decisive role in the rapid increase in CGM use.

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By state

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  • By gender

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  • By age

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  • By education group

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Results

In 2022, the prevalence of CGM use among children and adolescents aged 0 to 17 years with type 1 diabetes was 94.9% (girls: 95.0%; boys: 94.8%). With increasing age, the use of CGM decreases from 96.8% among under 3-year-olds to 93.7% among 14- to 17-year-olds. Before 2016, the frequency of CGM use was low (4.2% in 2014 and 6.3% in 2015). Since 2016, the use of CGM has increased sharply every year. There were hardly any discernible sex differences in the use of CGM over the entire observation period 2014 to 2022. The difference in the use of CGM between under 3-year-olds and 14- to 17-year-olds decreased from 47.3 percentage points in 2016 to 3.1 percentage points in 2022.

Conclusion

Almost all children and adolescents with type 1 diabetes in Germany currently use a CGM. There are hardly any differences in CGM use between boys and girls, and the differences between the age groups have narrowed over time. The use of CGM has increased significantly since 2016. It can be assumed that the reimbursement of costs by the statutory health insurers, which was introduced in 2016 (G-BA 2016), plays a decisive role in the rapid increase in CGM use, as does the development of new, user-friendly devices. The aim of CGM systems is to improve blood glucose control and, in particular, to prevent hypoglycaemia (Kamusheva et al. 2021). The effects of CGM use on glucose control and the safety of therapy in children and adolescents should be further investigated in the future.

Show more information on methodology and data sources

Definition

The indicator continuous glucose monitoring (CGM) is defined as the proportion of children and adolescents with type 1 diabetes who use continuous glucose monitoring.

Reference population

Children and adolescents aged between 0 and 17 years who are resident in Germany.

Data Sources

Nationwide and regional diabetes registers (DPV register, ESPED incidence register, North-Rhein Westphalia register, Saxony diabetes register). The data are based on the September 2023 data set from the DPV database, which has been fully validated and committed to the database.

Calculation

  • Description: The rate of continuous glucose monitoring use related to children and adolescents aged 0 to 17 years with type 1 diabetes in Germany during the 2014 to 2022 observation period.
  • Extrapolation/weighting: The extrapolated population data gathered by the Federal Statistical Office during the 2011 census were used for the nationwide estimates. Results with 95% confidence intervals were estimated using the person-years method. A Poisson distribution of cases was assumed (Woodward 2013; Sahai and Kurshid 1993).
  • Age standardisation: Estimates were standardised by age and sex and were equally weighted for the age groups under consideration.

Data quality of the participating centers

The diabetes registries provide outpatient or inpatient diagnostic data and information on the type of therapy provided to people with statutory and private health insurance. This includes information about people with different types of diabetes and age groups. These data are provided by practices and clinics participating on a voluntary basis. The data quality depends on the practice providing the data. All documentation is subject to a thorough plausibility check. Statistical methods are used for extrapolation and to ensure full coverage of the reference population.

Data download

Referencen and external links

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