Evaluation of daily glycemic profiles in well controlled children with type 1 diabetes mellitus using a continuous glucose monitoring system.

Introduction: Effective diabetes mellitus management requires to maintain blood glucose levels in a narrow range between hyperglycemia causing late complications, and danger of severe hypoglycemia. This objective may be difficult to achieve especially in small children.

The Aim Of The Study: Evaluation of daily glycemic profiles obtained using a continuous glucose monitoring system in well controlled children with type 1 diabetes mellitus.

Material And Methods: In 32 children (19 boys), aged 8.34+/-3.38 years, with a good metabolic control (HbA1c=6.59+/-0.66%), T1DM duration of 3.76+/-2.2 years, and daily insulin requirement of 0.69+/-0.2 U/kg, the Medtronic Guardian RT device was applied for 2.92+/-0.61 days. The data analysis performed in periods of day (7:00-22:00), night (22:00-7:00) and full recording consisted of following parameters: mean (mG) and standard deviation of glucose (sdG), excursion duration times (t) and mean glucose in following excursions (mGex): hyperglycemias >160 and >135 mg/dL (8.9 and 7.5 mmol/L), and hypoglycemias <55 and <70 mg/dL (3 and 3.9 mmol/L).

Results: The analyzed parameters did not vary between periods of day, night and full recording. For full recording values were: mG=120.9 mg/dL (6.72 mmol/L), sdG=39.73 mg/dL (2.18 mmol/L), t>135=32.04%, t>160=17.29%, mGex>135=169,78 mg/dL (9.43 mmol/L), mGex>160=189.2 mg/dL (10.51 mmol/L), t<55=0.91%, t<70=8.78%, Gex<55=51.99 mg/dL (2.89 mmol/L), mGex<70=63.18 mg/dL (3.51 mmol/L). The correlation coefficient values between HbA1c level and calculated parameters were the highest for full recording: mG r=0.44 (p<0.02), t>135 r=0.49 (p=0.005), t>160 r=0.45 (p=0.01), mGex>135 r=0.49 (p=0.005), mGex>160 r=0.47 (p<0.01). No significant correlations between the number of calibrations per day (6.62+/-2.53), and mG, t>135 and t>160 were found.

Conclusions: Continuous glucose monitoring showed almost-physiological glycemic profiles in well controlled children. Glycemic excursions times were very short.