Exploring the inter-subject variability in the relationship between glucose monitoring metrics and glycated hemoglobin for pediatric patients with type 1 diabetes
Author:
Bosoni Pietro1ORCID, Calcaterra Valeria23ORCID, Tibollo Valentina4ORCID, Malovini Alberto4ORCID, Zuccotti Gianvincenzo25ORCID, Mameli Chiara25ORCID, Sacchi Lucia1ORCID, Bellazzi Riccardo14ORCID, Larizza Cristiana1ORCID
Affiliation:
1. Department of Electrical, Computer and Biomedical Engineering , Università degli Studi di Pavia , Pavia , Italy 2. Pediatric Department , “Vittore Buzzi” Children’s Hospital , Milano , Italy 3. Pediatric and Adolescent Unit, Department of Internal Medicine , Università degli Studi di Pavia , Pavia , Italy 4. Istituti Clinici Scientifici Maugeri SpA-Società Benefit IRCCS , Pavia , Italy 5. Department of Biomedical and Clinical Science “L. Sacco” , Università degli Studi di Milano , Milano , Italy
Abstract
Abstract
Objectives
Despite the widespread diffusion of continuous glucose monitoring (CGM) systems, which includes both real-time CGM (rtCGM) and intermittently scanned CGM (isCGM), an effective application of CGM technology in clinical practice is still limited. The study aimed to investigate the relationship between isCGM-derived glycemic metrics and glycated hemoglobin (HbA1c), identifying overall CGM targets and exploring the inter-subject variability.
Methods
A group of 27 children and adolescents with type 1 diabetes under multiple daily injection insulin-therapy was enrolled. All participants used the isCGM Abbott’s FreeStyle Libre system on average for eight months, and clinical data were collected from the Advanced Intelligent Distant-Glucose Monitoring platform. Starting from each HbA1c exam date, windows of past 30, 60, and 90 days were considered to compute several CGM metrics. The relationships between HbA1c and each metric were explored through linear mixed models, adopting an HbA1c target of 7%.
Results
Time in Range and Time in Target Range show a negative relationship with HbA1c (R2>0.88) whereas Time Above Range and Time Severely Above Range show a positive relationship (R2>0.75). Focusing on Time in Range in 30-day windows, random effect represented by the patient’s specific intercept reveals a high variability compared to the overall population intercept.
Conclusions
This study confirms the relationship between several CGM metrics and HbA1c; it also highlights the importance of an individualized interpretation of the CGM data.
Publisher
Walter de Gruyter GmbH
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism,Pediatrics, Perinatology and Child Health
Reference26 articles.
1. Patterson, CC, Karuranga, S, Salpea, P, Saeedi, P, Dahlquist, G, Soltesz, G, et al.. Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract 2019;157:107842. 2. Nevo-Shenker, M, Phillip, M, Nimri, R, Shalitin, S. Type 1 diabetes mellitus management in young children: implementation of current technologies. Pediatr Res 2020;87:624–9. 3. Neu, A, Bürger-Büsing, J, Danne, T, Dost, A, Holder, M, Holl, RW, et al.. Diagnosis, therapy and follow-up of diabetes mellitus in children and adolescents. Exp Clin Endocrinol Diabetes 2019;127:341–52. 4. Braffett, BH, Gubitosi-Klug, RA, Albers, JW, Feldman, EL, Martin, CL, White, NH, et al.. Risk factors for diabetic peripheral neuropathy and cardiovascular autonomic neuropathy in the diabetes control and complications trial/epidemiology of diabetes interventions and complications (DCCT/EDIC) study. Diabetes 2020;69:1000–10. 5. Bebu, I, Schade, D, Braffett, B, Kosiborod, M, Lopes-Virella, M, Soliman, EZ, et al.. Risk factors for first and subsequent CVD Events in type 1 diabetes: the DCCT/EDIC study. Diabetes Care 2020;43:867–74.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|