Porcel-Chacón Rocio, Antúnez-Fernández Cristina, Mora Loro Maria, Ariza-Jimenez Ana-Belen, Tapia Ceballos Leopoldo, Jimenez Hinojosa Jose Manuel, Lopez-Siguero Juan Pedro, Leiva Gea Isabel
Pediatrics, Hospital Costa del Sol, 29603 Marbella, Spain.
Endocrinology and Diabetes, Hospital de Algeciras, 11207 Cadiz, Spain.
J Clin Med. 2021 Oct 24;10(21):4913. doi: 10.3390/jcm10214913.
Good metabolic control of Type 1 diabetes (T1D) leads to a reduction in complications. The only validated parameter for establishing the degree of control is glycated hemoglobin (HbA1c). We examined the relationship between HbA1c and a continuous glucose monitoring (CGM) system.
A cohort prospective study with 191 pediatric patients with T1D was conducted. Time in range (TIR), time below range (TBR), coefficient of variation (CV), number of capillary blood glucose tests, and HbA1c before sensor insertion and at one year of use were collected.
Patients were classified into five groups according to HbA1c at one year of using CGM. They performed fewer capillary blood glucose test at one year using CGM (-6 +/- 2, < 0.0001). We found statistically significant differences in TIR between categories. Although groups with HbA1c < 6.5% and HbA1c 6.5-7% had the highest TIR (62.214 and 50.462%), their values were highly below optimal control according to CGM consensus. Groups with TBR < 5% were those with HbA1c between 6.5% and 8%.
In our study, groups classified as well-controlled by guidelines were not consistent with good control according to the CGM consensus criteria. HbA1c should not be considered as the only parameter for metabolic control. CGM parameters allow individualized targets.
1型糖尿病（T1D）良好的代谢控制可减少并发症。用于确定控制程度的唯一经过验证的参数是糖化血红蛋白（HbA1c）。我们研究了HbA1c与连续血糖监测（CGM）系统之间的关系。
对191例儿童T1D患者进行了一项队列前瞻性研究。收集了传感器插入前和使用一年时的血糖达标时间（TIR）、血糖低于范围的时间（TBR）、变异系数（CV）、指尖血糖检测次数以及HbA1c。
根据使用CGM一年时的HbA1c将患者分为五组。使用CGM一年时，他们进行的指尖血糖检测次数减少（-6 +/- 2，< 0.0001）。我们发现不同类别之间的TIR存在统计学上的显著差异。尽管HbA1c < 6.5%和HbA1c 6.5 - 7%的组TIR最高（分别为62.214%和50.462%），但根据CGM共识，其值远低于最佳控制水平。TBR < 5%的组是HbA1c在6.5%至8%之间的组。
在我们的研究中，根据指南分类为控制良好的组与根据CGM共识标准的良好控制不一致。HbA1c不应被视为代谢控制的唯一参数。CGM参数允许制定个性化目标。
