Early hyperglycemia detected by continuous glucose monitoring in children at risk for type 1 diabetes.
OBJECTIVE
We explore continuous glucose monitoring (CGM) as a new approach to defining early hyperglycemia and diagnosing type 1 diabetes in children with positive islet autoantibodies (Ab+).


METHODS
Fourteen Ab+ children, free of signs or symptoms of diabetes, and nine antibody-negative (Ab-) subjects, followed by the Diabetes Autoimmunity Study in the Young, were asked to wear a Dexcom SEVEN CGM.


RESULTS
The Ab+ subjects showed more hyperglycemia, with 18% time spent above 140 mg/dL, compared with 9% in Ab- subjects (P = 0.04). Their average maximum daytime glucose value was higher, and they had increased glycemic variability. The mean HbA1c in the Ab+ subjects was 5.5% (37 mmol/mol). Among Ab+ subjects, ≥18-20% CGM time spent above 140 mg/dL seems to predict progression to diabetes.


CONCLUSIONS
CGM can detect early hyperglycemia in Ab+ children who are at high risk for progression to diabetes. Proposed CGM predictors of progression to diabetes require further validation.
Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO andrea.steck@ucdenver.edu.
Andrea K
AK
Steck
Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO.
Fran
F
Dong
Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO.
Iman
I
Taki
Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO.
Michelle
M
Hoffman
Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO.
Georgeanna J
GJ
Klingensmith
Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO.
Marian J
MJ
Rewers
D000293:Adolescent; D001323:Autoantibodies / Q000276:immunology*; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000276:immunology; D007515:Islets of Langerhans / Q000276:immunology; D008297:Male; D012306:Risk
D001323:Autoantibodies; D001786:Blood Glucose