title: Impact of Real-Time Continuous Glucose Monitoring Use on Glucose Variability and Endothelial Function in Adolescents with Type 1 Diabetes: New Technology--New Possibility to Decrease Cardiovascular Risk?
abstract: Children with type 1 diabetes (T1DM) are the high-risk group of accelerated atherosclerosis. Real-time continuous glucose monitoring (RT-CGM) provides possibilities for the detection of glycaemic variability, newly recognized cardiovascular risk factor. The aim of the study was to assess the usefulness of RT-CGM as an educational tool to find and reduce glycaemic variability in order to improve endothelial function in T1DM adolescents. Forty patients aged 14.6 years were recruited. The study was based on one-month CGM sensors use. Parameters of glycaemic variability were analyzed during first and last sensor use, together with brachial artery flow-mediated dilatation (FMD) to assess endothelial function. In the whole group, FMD improvement was found (10.9% to 16.6%, p < 0.005), together with decrease in all studied glycaemic variability parameters. In patients with HbA1c improvement compared to the group without HbA1c improvement, we found greater increase of FMD (12% to 19%, p < 0.005 versus 8.2% to 11.3%, p = 0.080) and greater improvement of glucose variability. RT-CGM can be considered as an additional tool that offers T1DM adolescents the quick reaction to decrease glycaemic variability in short time observation. Whether such approach might influence improvement in endothelial function and reduction of the risk of future cardiovascular disease remains to be elucidated.
authors.affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Subdivision, Medical University of Białystok, Jana Kilinskiego 1, 15-089 Białystok, Poland.
authors.forename: Milena
authors.initials: M
authors.lastname: Jamiołkowska
authors.affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Subdivision, Medical University of Białystok, Jana Kilinskiego 1, 15-089 Białystok, Poland.
authors.forename: Izabela
authors.initials: I
authors.lastname: Jamiołkowska
authors.affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Subdivision, Medical University of Białystok, Jana Kilinskiego 1, 15-089 Białystok, Poland.
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Łuczyński
authors.affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Subdivision, Medical University of Białystok, Jana Kilinskiego 1, 15-089 Białystok, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Tołwińska
authors.affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Subdivision, Medical University of Białystok, Jana Kilinskiego 1, 15-089 Białystok, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Bossowski
authors.affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Subdivision, Medical University of Białystok, Jana Kilinskiego 1, 15-089 Białystok, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Głowińska Olszewska
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D012039:Regional Blood Flow / Q000502:physiology; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin