title: Average Daily Risk Range (ADRR) in Young Children With Type 1 Diabetes.
abstract: OBJECTIVE
  The objective was to examine the utility of the average daily risk range (ADRR) in young children with type 1 diabetes.
  
  
  METHODS
  Self-monitored blood glucose (BG) data and A1c values were collected from 134 children (ages 2-6). Other measures of BG variability and diabetes care were calculated using self-monitored BG data. ADRR, A1c, and other glycemic indices were compared to assess their distinctiveness and utility as measures of BG variability and glycemic control.
  
  
  RESULTS
  Of young children's ADRR values, 72% were in the "high-risk" range using adult guidelines. ADRR and A1c were highly correlated with indicators of hyperglycemia but only weakly correlated with measures of hypoglycemia. ADRR was moderately correlated with minimum BG value in the past 30 days but not percentage of BG values below 70 mg/dL. A1c was not correlated with either measure of hypoglycemia.
  
  
  CONCLUSIONS
  ADRR values confirm the high degree of BG variability present in young children with type 1 diabetes, particularly as compared with adults. New ADRR risk guidelines are needed for pediatric patients. ADRR and A1c are adequate indicators of hyperglycemia in young children. However, both ADRR and A1c failed to effectively capture hypoglycemia risk in this sample, and neither ADRR nor A1c can take the place of review of raw BG data to evaluate BG variability in young children.
authors.affiliation: Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA mmonagha@childrensnational.org.
authors.forename: Maureen
authors.initials: M
authors.lastname: Monaghan
authors.affiliation: Children's National Medical Center, Washington, DC, USA.
authors.forename: Tamiko B
authors.initials: TB
authors.lastname: Younge
authors.affiliation: Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: McCarter
authors.affiliation: Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Fran R
authors.initials: FR
authors.lastname: Cogen
authors.affiliation: Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Randi
authors.initials: R
authors.lastname: Streisand
keywords: average daily risk range; blood glucose; glycemic variability; hemoglobin A1c; hypoglycemia risk; type 1 diabetes; young children