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Assessment of glycemic control by continuous glucose monitoring system in 50 children with type 1 diabetes starting on insulin pump therapy.
Pediatr Diabetes. 2004 Sep; 5(3):117-21.PD

Abstract

OBJECTIVE

To report experience with a continuous glucose monitoring system (CGMS) and to identify factors influencing glycemic control in a large cohort of children and adolescents with type 1 diabetes and change to insulin pump therapy via continuous subcutaneous insulin infusion (CSII).

RESEARCH DESIGN AND METHODS

In 50 patients [21 boys, 29 girls; median age 12.6 yr (range: 1.3-16.4 yr); diabetes duration 5.0 yr (0.2-13.3)], hemoglobin A1c (HbA1c) and ambulatory CGMS were performed before and 6 wk after starting CSII. Average glucose concentration per 24 h, during day and night time as well as number of excursions, duration, and area under the curve (AUC) of glucose values above 180 mg/dL and below 60 mg/dL were calculated from CGMS data. Simultaneously, metabolic control was documented by standardized self-monitoring of blood glucose (SMBG).

RESULTS

In the total cohort, HbA1c improved from 8.1 +/- 1.2% at baseline to 7.7 +/- 0.9% after 6 wk of CSII (p <0.001). This effect was more distinct in boys (8.0 +/- 1.4 vs. 7.5 +/- 1.1%, p=0.007) than in girls (8.1 +/- 1.1 vs. 7.8 +/- 0.7%, p=0.039) as well as in patients with poor glycemic control (HbA1c >8.0%) at baseline (8.9 +/- 0.6 vs. 8.1 +/- 0.8%, p <0.001) and in those older than 12 yr (8.2 +/- 1.2 vs. 7.7 +/- 1.0%, p <0.001). At 6 wk of CSII, the values of glucose average per 24 h, AUC and time above 180 mg/dL, particularly during the day, improved. HbA1c was correlated with AUC above 180 mg/dL (r=0.742, p <0.001) and CGMS average glucose per 24 h (r=0.628, p=0.002), but to a lesser extent with SMBG values (r=0.418, p=0.054).

CONCLUSION

With the change to CSII, HbA1c improved significantly after 6 wk of therapy. CGMS usage provided additional information about glycemic control in these patients.

Authors+Show Affiliations

Clinic of General Pediatrics, Otto-Heubner-Centrum, Charité, Campus Virchow-Klinikum, Humboldt-University, Berlin, Germany. dorothee.deiss@charite.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15450005

Citation

Deiss, Dorothee, et al. "Assessment of Glycemic Control By Continuous Glucose Monitoring System in 50 Children With Type 1 Diabetes Starting On Insulin Pump Therapy." Pediatric Diabetes, vol. 5, no. 3, 2004, pp. 117-21.
Deiss D, Hartmann R, Hoeffe J, et al. Assessment of glycemic control by continuous glucose monitoring system in 50 children with type 1 diabetes starting on insulin pump therapy. Pediatr Diabetes. 2004;5(3):117-21.
Deiss, D., Hartmann, R., Hoeffe, J., & Kordonouri, O. (2004). Assessment of glycemic control by continuous glucose monitoring system in 50 children with type 1 diabetes starting on insulin pump therapy. Pediatric Diabetes, 5(3), 117-21.
Deiss D, et al. Assessment of Glycemic Control By Continuous Glucose Monitoring System in 50 Children With Type 1 Diabetes Starting On Insulin Pump Therapy. Pediatr Diabetes. 2004;5(3):117-21. PubMed PMID: 15450005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of glycemic control by continuous glucose monitoring system in 50 children with type 1 diabetes starting on insulin pump therapy. AU - Deiss,Dorothee, AU - Hartmann,Reinhard, AU - Hoeffe,Julia, AU - Kordonouri,Olga, PY - 2004/9/29/pubmed PY - 2005/1/26/medline PY - 2004/9/29/entrez SP - 117 EP - 21 JF - Pediatric diabetes JO - Pediatr Diabetes VL - 5 IS - 3 N2 - OBJECTIVE: To report experience with a continuous glucose monitoring system (CGMS) and to identify factors influencing glycemic control in a large cohort of children and adolescents with type 1 diabetes and change to insulin pump therapy via continuous subcutaneous insulin infusion (CSII). RESEARCH DESIGN AND METHODS: In 50 patients [21 boys, 29 girls; median age 12.6 yr (range: 1.3-16.4 yr); diabetes duration 5.0 yr (0.2-13.3)], hemoglobin A1c (HbA1c) and ambulatory CGMS were performed before and 6 wk after starting CSII. Average glucose concentration per 24 h, during day and night time as well as number of excursions, duration, and area under the curve (AUC) of glucose values above 180 mg/dL and below 60 mg/dL were calculated from CGMS data. Simultaneously, metabolic control was documented by standardized self-monitoring of blood glucose (SMBG). RESULTS: In the total cohort, HbA1c improved from 8.1 +/- 1.2% at baseline to 7.7 +/- 0.9% after 6 wk of CSII (p <0.001). This effect was more distinct in boys (8.0 +/- 1.4 vs. 7.5 +/- 1.1%, p=0.007) than in girls (8.1 +/- 1.1 vs. 7.8 +/- 0.7%, p=0.039) as well as in patients with poor glycemic control (HbA1c >8.0%) at baseline (8.9 +/- 0.6 vs. 8.1 +/- 0.8%, p <0.001) and in those older than 12 yr (8.2 +/- 1.2 vs. 7.7 +/- 1.0%, p <0.001). At 6 wk of CSII, the values of glucose average per 24 h, AUC and time above 180 mg/dL, particularly during the day, improved. HbA1c was correlated with AUC above 180 mg/dL (r=0.742, p <0.001) and CGMS average glucose per 24 h (r=0.628, p=0.002), but to a lesser extent with SMBG values (r=0.418, p=0.054). CONCLUSION: With the change to CSII, HbA1c improved significantly after 6 wk of therapy. CGMS usage provided additional information about glycemic control in these patients. SN - 1399-543X UR - https://www.unboundmedicine.com/medline/citation/15450005/Assessment_of_glycemic_control_by_continuous_glucose_monitoring_system_in_50_children_with_type_1_diabetes_starting_on_insulin_pump_therapy_ L2 - https://doi.org/10.1111/j.1399-543X.2004.00053.x DB - PRIME DP - Unbound Medicine ER -