Time spent outside of target glucose range for young children with type 1 diabetes: a continuous glucose monitor study

Abstract

Aim 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.

Research design and methods 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 HbA1c concentration 53 to <86 mmol/mol (7.0 to <10.0%). All participants wore masked continuous glucose monitors up to 14 days.

Results 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.

Conclusions Given that both hypo- and hyperglycaemia negatively impact neurocognitive development, strategies to increase time in target glucose range for young children are needed.

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DiMeglio, L. A., Kanapka, L. G., DeSalvo, D. J., Anderson, B. J., Harrington, K. R., Hilliard, M. E., Laffel, L. M., Tamborlane, W. V., Van Name, M. A., Wadwa, R. P., Willi, S. M., Woerner, S., Wong, J. C., Miller, K. M., & SENCE Study Group. (2020). Time spent outside of target glucose range for young children with type 1 diabetes: A continuous glucose monitor study. Diabetic Medicine: A Journal of the British Diabetic Association, 37(8), 1308–1315. https://doi.org/10.1111/dme.14276
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