Gandrud Laura M, Xing Dongyuan, Kollman Craig, Block Jen M, Kunselman Betsy, Wilson Darrell M, Buckingham Bruce A
Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
Diabetes Technol Ther. 2007 Aug;9(4):307-16. doi: 10.1089/dia.2007.0026.
The glycemic patterns of children less than 7 years with type 1 diabetes have not been well studied using continuous glucose monitoring. Our goal was to assess the incidence of hypoglycemia as well as postprandial glycemic patterns in this age group utilizing continuous glucose monitoring.
Nineteen children used the Medtronic MiniMed (Northridge, CA) CGMS System Gold on three to seven occasions over approximately 6 months.
Nineteen children (nine girls and 10 boys; mean age 4.8 +/- 1.4 years, range 1.6-6.8 years) used the CGMS 102 times, providing 434 days of data; 79% of days were optimal based on CGMS Solutions software version 3.0. Mild hypoglycemia (glucose <or=70 mg/dL) was noted during 28% of 323 nights. When compared to paired meter blood glucose values, the false-positive rate was 16% for mild and 55% for severe sensor hypoglycemia. The mean peak glucose during the 3 h following breakfast (247 +/- 64 mg/dL) was higher than following lunch (199 +/- 67 mg/dL) or dinner (194 +/- 63 mg/dL). The rate of glucose rise to peak was >or=2 mg/dL/min following 50% of breakfasts. Children with hemoglobin A1c levels >or=8% had higher postprandial glucose concentrations. There was no significant advantage of continuous subcutaneous insulin infusion therapy over multiple daily injection therapy in decreasing postprandial hyperglycemia.
CGMS tracings from young children with diabetes demonstrate frequent mild nocturnal hypoglycemia and significant postprandial hyperglycemia, with a rapid rise in glucose following the meal. The most rapid rate of rise and the most severe postprandial hyperglycemia occurred after breakfast.
对于1型糖尿病的7岁以下儿童的血糖模式，尚未通过持续血糖监测进行充分研究。我们的目标是利用持续血糖监测评估该年龄组低血糖的发生率以及餐后血糖模式。
19名儿童在大约6个月内使用美敦力MiniMed（加利福尼亚州诺斯里奇）CGMS系统金型3至7次。
19名儿童（9名女孩和10名男孩；平均年龄4.8±1.4岁，范围1.6 - 6.8岁）使用CGMS 102次，提供了434天的数据；根据CGMS Solutions软件版本3.0，79%的天数数据质量良好。在323个夜间中，28%记录到轻度低血糖（血糖≤70mg/dL）。与配对的血糖仪血糖值相比，轻度传感器低血糖的假阳性率为16%，重度为55%。早餐后3小时内的平均血糖峰值（247±64mg/dL）高于午餐后（199±67mg/dL）或晚餐后（194±63mg/dL）。50%的早餐后血糖上升至峰值的速率≥2mg/dL/分钟。糖化血红蛋白水平≥8%的儿童餐后血糖浓度更高。在降低餐后高血糖方面，持续皮下胰岛素输注治疗与多次每日注射治疗相比没有显著优势。
糖尿病幼儿的CGMS记录显示频繁出现轻度夜间低血糖和显著的餐后高血糖，且餐后血糖快速上升。早餐后血糖上升速率最快，餐后高血糖最严重。
