Pediatric Clinic, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
Pediatric Department, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
Front Endocrinol (Lausanne). 2024 Jun 18;15:1388245. doi: 10.3389/fendo.2024.1388245. eCollection 2024.
From the introduction of continuous glucose monitoring (CGM) in treatments of type 1 diabetes, particularly its integration with insulin pumps, there has been a quest for new parameters that describe optimal glycemic control. As of the consensus reached in 2019, the ambulatory glucose profile (AGP) has become the standard, with time in range (TIR) emerging as a fundamental parameter for metabolic control assessment. However, with technological advancements, new parameters, such as the glycemia risk index (GRI), have been introduced and clinically utilized. Therefore, exploring the relationships between traditional and novel parameters to understand metabolic control comprehensively is imperative.
This study was conducted at the Pediatric Clinic of the University Hospital of the Republic of Srpska Banja Luka between January and July 2023. The participants were randomly selected, with the inclusion criteria specifying an age greater than eight years and a diabetes type 1 duration exceeding two years. All participants were required to use a sensor-augmented insulin pump for the next three months (90 days), irrespective of prior use, with the suspend-before-low option activated.
Of the 35 participants, 30 completed the study, 14 (46.7%) of whom were male. The mean age of the subjects was 14.90 ± 2.88 years, and the mean duration of diabetes was 7.83 ± 4.76 years. Over the 90-day period, HbA1c increased to an average of 7.31%. The analysis revealed significant effects of TIR (β=-0.771) and GRI (β=0.651) on HbA1c. Furthermore, GRI and TIR strongly correlated (β=-0.953).
New parameters generated from the ambulatory glucose profile (AGP) can help clinicians create a complete picture of a patient's metabolic control in relation to HbA1c levels. Additionally, the GRI is a mathematically tailored parameter that incorporates all components of the ambulatory glucose profile and demonstrates strong correlations with laboratory-measured HbA1c and TIR. The GRI potentially can become a valuable statistical parameter for evaluating and managing patients in routine clinical practice.
自 1 型糖尿病治疗中引入连续血糖监测（CGM），特别是与胰岛素泵的整合以来，人们一直在寻找新的参数来描述最佳血糖控制。截至 2019 年达成的共识，动态血糖谱（AGP）已成为标准，TIR 作为代谢控制评估的基本参数出现。然而，随着技术的进步，已经引入了新的参数，如血糖风险指数（GRI），并在临床上得到了应用。因此，探索传统和新型参数之间的关系，全面了解代谢控制是至关重要的。
本研究于 2023 年 1 月至 7 月在塞族共和国巴尼亚卢卡大学医院的儿科诊所进行。参与者是随机选择的，纳入标准为年龄大于 8 岁，1 型糖尿病病程超过 2 年。所有参与者均被要求在接下来的三个月（90 天）内使用传感器增强型胰岛素泵，无论之前是否使用过，均激活低电量暂停功能。
在 35 名参与者中，有 30 名完成了研究，其中 14 名（46.7%）为男性。受试者的平均年龄为 14.90 ± 2.88 岁，糖尿病病程的平均时间为 7.83 ± 4.76 年。在 90 天期间，HbA1c 升高至平均 7.31%。分析显示 TIR（β=-0.771）和 GRI（β=0.651）对 HbA1c 有显著影响。此外，GRI 和 TIR 之间存在强烈的相关性（β=-0.953）。
从动态血糖谱（AGP）生成的新参数可以帮助临床医生根据 HbA1c 水平全面了解患者的代谢控制情况。此外，GRI 是一个数学上量身定制的参数，它结合了动态血糖谱的所有成分，并与实验室测量的 HbA1c 和 TIR 显示出强烈的相关性。GRI 有可能成为评估和管理常规临床实践中患者的有价值的统计参数。
