Monaghan Maureen, Younge Tamiko B, McCarter Robert, Cogen Fran R, Streisand Randi
Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA
Children's National Medical Center, Washington, DC, USA.
J Diabetes Sci Technol. 2014 Jan;8(1):70-73. doi: 10.1177/1932296813511734. Epub 2014 Jan 1.
The objective was to examine the utility of the average daily risk range (ADRR) in young children with type 1 diabetes.
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.
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.
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.
本研究旨在探讨平均每日风险范围（ADRR）在1型糖尿病幼儿中的应用价值。
收集了134名2至6岁儿童的自我监测血糖（BG）数据和糖化血红蛋白（A1c）值。使用自我监测的BG数据计算BG变异性和糖尿病护理的其他指标。比较ADRR、A1c和其他血糖指标，以评估它们作为BG变异性和血糖控制指标的独特性和实用性。
按照成人指南，72%的幼儿ADRR值处于“高风险”范围。ADRR和A1c与高血糖指标高度相关，但与低血糖指标的相关性较弱。ADRR与过去30天的最低BG值中度相关，但与低于70mg/dL的BG值百分比无关。A1c与任何一项低血糖指标均无相关性。
ADRR值证实了1型糖尿病幼儿存在高度的BG变异性，尤其是与成人相比。儿科患者需要新的ADRR风险指南。ADRR和A1c是幼儿高血糖的充分指标。然而，在本样本中，ADRR和A1c均未能有效捕捉低血糖风险，ADRR和A1c都不能替代对原始BG数据的审查来评估幼儿的BG变异性。
