Real-time Continuous Glucose Monitoring Outperforms Blood Glucose Meters in Predicting Diabetes Risk Among Children with Acanthosis Nigricans: A Nine-Month Observational Study

Background: The rising prevalence of diabetes mellitus in children necessitates precise glucose monitoring for early detection and intervention. Blood Glucose Meters (BGM) and Continuous Glucose Monitoring (CGM) are widely used, yet their effectiveness in predicting diabetes onset in at-risk paediatric populations remains debated. This study aimed tocompare BGM and CGM in predicting diabetes risk among children with Acanthosis Nigricans (AN) and elevated FINDRISC scores.Methods: A quasi-experimental study was conducted at the Health Polytechnic of the Ministry of Health Sorong over nine months (January–September 2024), involving 76 children aged 10–18 years. Participants were assigned to either the BGM group (measurements every three days) or the CGM group (continuous monitoring every 15 minutes). Key parameters included Time in Range (TIR), mean glucose levels, hypoglycaemia and hyperglycaemia episodes, and adherence rates.Results: CGM demonstrated superior performance, with a significantly higher TIR (78.9% vs. 63.4%, p<0.001), lower mean glucose levels (145.3 vs. 162.7 mg/dL, p=0.003), and fewer hypoglycaemia (1.1 vs. 2.8, p=0.015) and hyperglycaemia episodes (2.6 vs. 4.5, p=0.002). CGM users also exhibited higher adherence (88.7% vs. 71.3%, p<0.001) and greater accuracy, as indicated by a lower Mean Absolute Relative Difference (MARD) (7.2% vs. 10.8%, p=0.004).Conclusions: CGM outperforms BGM in predicting diabetes onset in at-risk children, offering improved glycaemic control and adherence. These findings support CGM as the preferred glucose monitoring method for paediatric populations at risk of diabetes