Evaluation of daily glycemic profiles in well controlled children with type 1 diabetes mellitus using a continuous glucose monitoring system.
BACKGROUND
Effective diabetes mellitus management requires to maintain blood glucose levels in a narrow range between hyperglycemia causing late complications, and danger of severe hypoglycemia. This objective may be difficult to achieve especially in small children.


OBJECTIVE
Evaluation of daily glycemic profiles obtained using a continuous glucose monitoring system in well controlled children with type 1 diabetes mellitus.


METHODS
In 32 children (19 boys), aged 8.34+/-3.38 years, with a good metabolic control (HbA1c=6.59+/-0.66%), T1DM duration of 3.76+/-2.2 years, and daily insulin requirement of 0.69+/-0.2 U/kg, the Medtronic Guardian RT device was applied for 2.92+/-0.61 days. The data analysis performed in periods of day (7:00-22:00), night (22:00-7:00) and full recording consisted of following parameters: mean (mG) and standard deviation of glucose (sdG), excursion duration times (t) and mean glucose in following excursions (mGex): hyperglycemias >160 and >135 mg/dL (8.9 and 7.5 mmol/L), and hypoglycemias <55 and <70 mg/dL (3 and 3.9 mmol/L).


RESULTS
The analyzed parameters did not vary between periods of day, night and full recording. For full recording values were: mG=120.9 mg/dL (6.72 mmol/L), sdG=39.73 mg/dL (2.18 mmol/L), t>135=32.04%, t>160=17.29%, mGex>135=169,78 mg/dL (9.43 mmol/L), mGex>160=189.2 mg/dL (10.51 mmol/L), t<55=0.91%, t<70=8.78%, Gex<55=51.99 mg/dL (2.89 mmol/L), mGex<70=63.18 mg/dL (3.51 mmol/L). The correlation coefficient values between HbA1c level and calculated parameters were the highest for full recording: mG r=0.44 (p<0.02), t>135 r=0.49 (p=0.005), t>160 r=0.45 (p=0.01), mGex>135 r=0.49 (p=0.005), mGex>160 r=0.47 (p<0.01). No significant correlations between the number of calibrations per day (6.62+/-2.53), and mG, t>135 and t>160 were found.


CONCLUSIONS
Continuous glucose monitoring showed almost-physiological glycemic profiles in well controlled children. Glycemic excursions times were very short.
Tucholski
Krzysztof
K
Diabetes Clinic, Child and Mother's Health Centre, Katowice, Poland.
Deja
Grazyna
G
Skała-Zamorowska
Eliza
E
Jarosz-Chobot
Przemysława
P
D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D002648:Child; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D038321:Glycemic Index / Q000187:drug effects*; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D007003:Hypoglycemia / Q000453:epidemiology; D015994:Incidence; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D008297:Male
D001786:Blood Glucose; D007328:Insulin