Achievement of target A1C levels with negligible hypoglycemia and low glucose variability in youth with short-term type 1 diabetes and residual β-cell function.
Achievement of target A1C levels with negligible hypoglycemia and low glucose variability in youth with short-term type 1 diabetes and residual β-cell function.
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DOI：
10.2337/dc11-2190
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发表时间：
2012-04
期刊：
影响因子：
16.2
通讯作者：
Diabetes Research in Children Network (DirecNet) Study Group
中科院分区：
文献类型：
--
作者：
Sherr J;Tamborlane WV;Xing D;Tsalikian E;Mauras N;Buckingham B;White NH;Arbelaez AM;Beck RW;Kollman C;Ruedy K;Diabetes Research in Children Network (DirecNet) Study Group
目的：使用盲法连续血糖监测(Cgm)资料，确定在胰岛素治疗的第一年中，有β细胞功能残留的青年1型糖尿病(T1D)患者暴露于高血糖和低血糖环境中。16例短期T1D患者(年龄8~18岁，T1D持续时间6~52周)在混餐耐量试验中C肽峰值范围为0.46~1.96nmol/L。结果将该短期组与控制良好、长期T1D(持续时间≥为5年)、年龄和A1C相匹配的34例患者与短期T1D组进行比较，并与26名年龄匹配的非糖尿病患者进行比较。尽管两个T1D组的A1C水平相匹配，因此传感器的平均血糖水平相似，但短期T1D参与者的低血糖发生率较低(0.3vs.7.6%，P<；0.001)，有较少高血糖的趋势(17vs.32%，P=0.15)，且在目标范围内的百分比较高(中位数77vs.60%，P=0.02)。事实上，短期T1D组的传感器血糖水平≤70 mg/dL的百分比(0.3%)与非糖尿病组(1.7%，P=0.73)没有差别。短期受试者与长期受试者相比，传感器血糖水平(葡萄糖变异性的一个指标)的变异系数较低(分别为27%和42%，P<；0.001)。短期T1D患者保留残留的β细胞功能，与T1D控制良好且持续时间较长的年轻人相比，低血糖和较低的血糖变异性可以忽略不计。
To determine exposure to hyper- and hypoglycemia using blinded continuous glucose monitoring (CGM) profiles in youth with type 1 diabetes (T1D) with residual β-cell function during the first year of insulin treatment. Blinded, 3–7 day CGM profiles were obtained in 16 short-term T1D patients (age 8–18 years, T1D duration 6–52 weeks) who had peak C-peptide levels ranging from 0.46 to 1.96 nmol/L during a mixed-meal tolerance test. Results in this short-term group were compared with those in 34 patients with well-controlled, longer-term T1D (duration ≥5 years), matched for age and A1C with the short-term T1D group, and with those in 26 age-matched nondiabetic individuals. Despite matching for A1C, and therefore similar mean sensor glucose levels in the two T1D groups, short-term T1D participants had a lower frequency of hypoglycemia (0.3 vs. 7.6%, P < 0.001), a trend toward less hyperglycemia (17 vs. 32%, P = 0.15), and a greater percentage in the target range (median 77 vs. 60%, P = 0.02). Indeed, the percentage of sensor glucose levels ≤70 mg/dL in the short-term T1D group (0.3%) did not differ from those in the nondiabetic group (1.7%, P = 0.73). The coefficient of variation of sensor glucose levels (an index of glucose variability) was lower in short-term vs. longer-term T1D participants (27 vs. 42%, respectively, P < 0.001). In youth with short-term T1D who retain residual β-cell function, there is negligible exposure to hypoglycemia and lower glucose variability than in youth with well-controlled T1D of longer duration.
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影响因子：
16.2
作者：
Beck, Roy W.
通讯作者：
Beck, Roy W.
影响因子：
8
作者：
Weinzimer, SA;Ahern, JH;Tamborlane, WV
通讯作者：
Tamborlane, WV
影响因子：
16.2
作者：
Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group;Fox LA;Beck RW;Xing D
通讯作者：
Xing D
影响因子：
16.2
作者：
Wilson, Darrell M.;Beck, Roy W.;Weinzimer, Stuart A.
通讯作者：
Weinzimer, Stuart A.
影响因子：
158.5
作者：
Herold, KC;Hagopian, W;Bluestone, JA
通讯作者：
Bluestone, JA