Unrecognised hypoglycaemia in children and adolescents with type 1 diabetes using the continuous glucose monitoring system: Prevalence and contributors
Unrecognised hypoglycaemia in children and adolescents with type 1 diabetes using the continuous glucose monitoring system: Prevalence and contributors
复制标题
DOI：
10.1111/j.1440-1754.2006.00973.x
复制
发表时间：
2006-12-01
影响因子：
1.7
通讯作者：
McTavish, Lindsay
中科院分区：
文献类型：
--
作者：
Wiltshire, Esko J.;Newton, Kirsty;McTavish, Lindsay
目的：利用美敦力低血糖连续监测系统（CGMS）确定1型糖尿病儿童低血糖的患病率及其影响因素。方法：采用CGMS对51例糖尿病儿童和青少年进行研究。这些研究分析了低血糖的频率和持续时间（低于3.5和2.5 mmol/L）。确定影响临床因素。夜间低血糖的发生与睡前和空腹血糖记录有关。结果：低血糖很常见，每例患者每24小时发生1（0-4.2）次（中位（范围））次，每例患者每晚发生0.33（0-2）次。低于3.5 mmol/L时，夜间发作时间长于白天发作时间[97.5（5-720）分钟比35（5-295）分钟，P < 0.001；低于2.5 mmol/L的发作时间为75（10-640）分钟，而低于2.5 mmol/L的发作时间为25（5-200）分钟，P < 0.001]，并且不太可能被受试者识别（低于3.5和2.5 mmol/L的发作时间P < 0.001）。夜间低血糖在睡前血糖记录< 6 mmol/L时更为常见，但也经常发生在血糖记录< 10 mmol/L的受试者中。无睡前血糖值可将夜间低血糖的风险降低至< 10%。结论：使用CGMS评估的低血糖在1型糖尿病儿童中很常见，并且可以延长（尽管主要是轻微的）。睡前家庭血糖记录不能很好地预测第二天晚上的低血糖。连续血糖监测已被证明在个别患者的管理中非常有用，特别是在坚持糖尿病管理方面遇到困难的青少年。
Aim: To determine prevalence of hypoglycaemia, and contributing factors, in children with type 1 diabetes, using the Medtronic MiniMed continuous glucose monitoring system (CGMS).Methods: Fifty-one children and adolescents with diabetes were studied with the CGMS. The studies were analysed for frequency and duration of hypoglycaemia (below 3.5 and 2.5 mmol/L). Contributing clinical factors were determined. Occurrence of nocturnal hypoglycaemia was related to bedtime and fasting home glucose recording.Results: Hypoglycaemia was common, with 1 (0-4.2) (median (range)) episode per patient per 24 hours, and 0.33 (0-2) episodes per patient per night. Nocturnal episodes were longer than daytime episodes [97.5 (5-720) versus 35 (5-295) minutes for episodes below 3.5 mmol/L, P < 0.001; and 75 (10-640) versus 25 (5-200) minutes for episodes below 2.5 mmol/L, P < 0.001], and less likely to be recognised by the subject (P < 0.001 for episodes below both 3.5 and 2.5 mmol/L). Nocturnal hypoglycaemia was more common with a bedtime glucose recording < 6 mmol/L, but also occurred frequently in subjects with glucose recordings > 10 mmol/L. No bedtime glucose value reduced the risk of nocturnal hypoglycaemia to < 10%.Conclusion: Hypoglycaemia, assessed using the CGMS, is common in children with type 1 diabetes and can be prolonged (although is predominantly mild). Bedtime home glucose recordings are poorly predictive of hypoglycaemia during the following night. Continuous glucose monitoring has proven very useful in management of individual patients, particularly adolescents experiencing difficulties with adherence to diabetes management.