Indiana University School of Medicine, Indianapolis, IN, USA.
Jaeb Center for Health Research, Tampa, FL, USA.
Diabet Med. 2020 Aug;37(8):1308-1315. doi: 10.1111/dme.14276. Epub 2020 Mar 17.
To assess the associations between demographic and clinical characteristics and sensor glucose metrics in young children with type 1 diabetes, using masked, continuous glucose monitoring data from children aged 2 to < 8 years.
The analysis included 143 children across 14 sites in the USA, enrolled in a separate clinical trial. Eligibility criteria were: age 2 to <8 years; type 1 diabetes duration ≥3 months; no continuous glucose monitoring use for past 30 days; and HbA concentration 53 to <86 mmol/mol (7.0 to <10.0%). All participants wore masked continuous glucose monitors up to 14 days.
On average, participants spent the majority (13 h) of the day in hyperglycaemia (>10.0 mmol/l) and a median of ~1 h/day in hypoglycaemia (<3.9 mmol/l). Participants with minority race/ethnicity and higher parent education levels spent more time in target range, 3.9-10.0 mmol/l, and less time in hyperglycaemia. More time in hypoglycaemia was associated with minority race/ethnicity and younger age at diagnosis. Continuous glucose monitoring metrics were similar in pump and injection users.
Given that both hypo- and hyperglycaemia negatively impact neurocognitive development, strategies to increase time in target glucose range for young children are needed.
使用来自美国 14 个地点、年龄在 2 至<8 岁的儿童的掩蔽式连续血糖监测数据，评估 1 型糖尿病儿童的人口统计学和临床特征与传感器血糖指标之间的关联。
该分析纳入了美国 14 个地点的 143 名儿童，他们参加了一项单独的临床试验。入选标准为：年龄 2 至<8 岁；1 型糖尿病病程≥3 个月；过去 30 天内未使用连续血糖监测；且 HbA 浓度为 53 至<86 mmol/mol（7.0 至<10.0%）。所有参与者佩戴掩蔽式连续血糖监测仪长达 14 天。
平均而言，参与者大部分时间（13 小时）处于高血糖（>10.0mmol/l）状态，每天有中位数约 1 小时处于低血糖（<3.9mmol/l）状态。少数族裔和父母受教育程度较高的参与者处于目标范围（3.9-10.0mmol/l）的时间更长，处于高血糖状态的时间更短。少数族裔和诊断时年龄较小与更多的低血糖时间有关。泵和注射使用者的连续血糖监测指标相似。
鉴于低血糖和高血糖都会对神经认知发育产生负面影响，需要制定策略来增加儿童目标血糖范围内的时间。
