title: Evaluation of the Average Daily Risk Range as a Measure of Glycemic Variability in Youths with Type 1 Diabetes.
abstract: OBJECTIVE
  The Average Daily Risk Range (ADRR) is a measure of glycemic variability (GV) developed for adults with diabetes. Although the ADRR is increasingly being reported in pediatric diabetes research and may also be used in clinical management, it has never been examined for its sensitivity to predicting hyper- and hypoglycemia in youths or compared for its predictive ability with other measures of GV in youths. Thus, we present predictive validity data for the ADRR in youths with type 1 diabetes.
  
  
  METHODS
  Glucometer data for 436 youths (mean age, 11.8±3.8 years) were collected from a clinical database. Using these data, we computed the ADRR, SD of blood glucose, coefficient of variation of blood glucose, Low Blood Glucose Index, High Blood Glucose Index, the percentage of glucose values ≥70 and ≤180 mg/dL, the percentage of high glucose values >180 mg/dL and >400 mg/dL, and the percentage of low glucose values <70 mg/dL and <40 mg/dL in Month 1. We then compared these with episodes of hypo- and hyperglycemia in Month 2.
  
  
  RESULTS
  The ADRR showed good concurrent validity with other measures of GV in youths experiencing hyperglycemic events but limited predictive validity in general and specifically with future hypoglycemic events. The percentages of current hyper- and hypoglycemic episodes appeared to be stronger predictors of future hyper- and hypoglycemic episodes, respectively.
  
  
  CONCLUSIONS
  In a large pediatric sample, the ADRR was not the strongest predictor of future glycemic excursion. The percentages of current hyper- and hypoglycemic episodes appear to be stronger predictors.
authors.affiliation: 1 Division of Behavorial Pediatrics, Department of Pediatrics, University of Kansas Medical Center , Kansas City, Kansas.
authors.forename: Susana R
authors.initials: SR
authors.lastname: Patton
authors.affiliation: 2 Children's Mercy Hospital , Kansas City, Missouri.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: DeLurgio
authors.affiliation: 3 Division of Endocrinology, Children's Mercy Hospital , Kansas City, Missouri.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Clements
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000592:standards*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000209:etiology; D007003:Hypoglycemia / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D011237:Predictive Value of Tests; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose