Clinically Serious Hypoglycemia Is Rare and Not Associated With Time-in-range in Youth With New-onset Type 1 Diabetes
Clinically Serious Hypoglycemia Is Rare and Not Associated With Time-in-range in Youth With New-onset Type 1 Diabetes
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DOI：
10.1210/clinem/dgab522
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发表时间：
2021-07-15
影响因子：
5.8
通讯作者：
Maahs, David M.
中科院分区：
文献类型：
--
作者：
Addala, Ananta;Zaharieva, Dessi P.;Maahs, David M.
背景：1型糖尿病（T1 D）青年患者提倡早期开始动态血糖监测（CGM）。指导CGM在范围内时间（TIR）、低血糖和部分临床缓解（PCR）作用方面的数据有限。目的：我们的目的是评估1）TIR增加和低血糖之间是否存在关联，以及2）低血糖时间如何因PCR状态而变化。方法：我们分析了80名在T1 D诊断后不久开始CGM的青年，并在诊断后随访长达1年。通过CGM数据确定TIR和低血糖发生率，并进行回顾性分析。PCR定义为（访视糖化血红蛋白A（1c））+（4* 单位/kg/d）<9。结果：青年患者在确诊后8.0（四分位距，6.0-13.0）天开始CGM。尽管TIR发生变化，但低于70 mg/dL的时间仍然较低（诊断后1个月时最高TIR为74.6 ± 16.7%，低血糖为2.4 ± 2.4%;诊断后12个月时最低TIR为61.3 ± 20.3%，低血糖为2.1 ± 2.7%）。未发生重度低血糖事件。低血糖是罕见的，PCR与非PCR青年的差异很小（54-70 mg/dL：1.8% vs 1.2%，P= 0.04;
Context: Early initiation of continuous glucose monitoring (CGM) is advocated for youth with type 1 diabetes (T1D). Data to guide CGM use on time-in-range (TIR), hypoglycemia, and the role of partial clinical remission (PCR) are limited.Objective: Our aims were to assess whether 1) an association between increased TIR and hypoglycemia exists, and 2) how time in hypoglycemia varies by PCR status.Methods: We analyzed 80 youth who were started on CGM shortly after T1D diagnosis and were followed for up to 1-year post diagnosis. TIR and hypoglycemia rates were determined by CGM data and retrospectively analyzed. PCR was defined as (visit glycated hemoglobin A(1c))+(4*units/kg/day) less than 9.Results: Youth were started on CGM 8.0 (interquartile range, 6.0-13.0) days post diagnosis. Time spent at less than 70 mg/dL remained low despite changes in TIR (highest TIR 74.616.7%, 2.4 +/- 2.4% hypoglycemia at 1 month post diagnosis; lowest TIR 61.3 +/- 20.3%, 2.1 +/- 2.7% hypoglycemia at 12 months post diagnosis). No events of severe hypoglycemia occurred. Hypoglycemia was rare and there was minimal difference for PCR vs non-PCR youth (54-70 mg/dL: 1.8% vs 1.2%, P=.04;