Prevention of Nocturnal Hypoglycemia: Effect on Neurologic Outcome in Toddlers

预防夜间低血糖：对幼儿神经系统结果的影响

• 批准号: 7681021
• 负责人: BRUCE A BUCKINGHAM
• 金额: $ 22.12万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7681021
• 关键词: 5 year old; 8 year old; Adolescent; Age-Years; Aged, 80 and over; Algorithms; Anesthesia procedures; Anisotropy; Area; Attention; Auditory; Beds; Blood Glucose; Brain; Brain imaging; Cerebrum; Child; Classification; Control Groups; Data; Detection; Development; Diabetes Mellitus; Diffusion Magnetic Resonance Imaging; Eating; Effectiveness; Evaluation; Event; Frequencies; Fright; Future; Glucose; Glycosylated hemoglobin A; Goals; Hippocampus (Brain); Home environment; Hyperglycemia; Hypoglycemia; Imaging Techniques; Incidence; Insulin; Insulin-Dependent Diabetes Mellitus; Intervention; Laboratories; Longitudinal Studies; MRI Scans; Magnetic Resonance Imaging; Measurement; Measures; Memory; Monitor; Neurocognitive; Neurologic; Neurological outcome; Neuropsychological Tests; Observational Study; Outcome Measure; Parents; Patients; Physical activity; Physiological; Population; Prevention; Publishing; Quality of life; Randomized; Randomized Controlled Clinical Trials; Reactive hypoglycemia; Reading; Research Personnel; Risk; Security; Seizures; Severities; Siblings; Sleep; Structure; System; Testing; Time; Toddler; Unconscious State; Visual; age group; clinically significant; cognitive function; design; diabetes management; diabetic; early onset; glucose monitor; glucose sensor; glycemic control; gray matter; high risk; improved; indexing; lifetime risk; neurocognitive test; neuropsychological; non-diabetic; prevent; prospective; psychologic; sensor; skills; tool; vigilance; white matter

DESCRIPTION (prepared by applicant): The investigators propose to develop a systematic approach to evaluating near continuous glucose sensors in children and adolescents. This approach can be used in the assessment of current sensors now available to the public, and for future sensors that become available during this project. Accuracy will be determined using normal controls and children with diabetes. Initial accuracy measurements will be performed in a CRC using a laboratory quality measurement of glucose. The sensors will then be assessed in the home environment to determine their usefulness in detecting changes in blood glucose levels and improving diabetes management. The investigators will collect detailed record of food intake, and a continuous record of physical activity will be obtained using an accelerometer as well as psychological assessments. These data will be integrated to evaluate the multiple factors leading to hypoglycemia and variability in blood glucose levels, as well as provide effective tools for improving diabetes management. In the future these data will be valuable in developing algorithms that incorporate this information into a closed loop insulin delivery system. Aim 1 is to determine the accuracy of near-continuous glucose monitors in normal children. This will allow assessment of the possible physiologic effects, such as sleep and physical activity on glucose levels. These studies will also allow determination of the incidence of sensor readings in the hypoglycemic range despite normal blood glucose levels. Aim 2 is to determine the accuracy of near-continuous glucose sensors in children with diabetes. Particular attention will be given to the detection of hypoglycemia, especially nocturnal hypoglycemia, and the accuracy of sensors during physical activity. Aim 3 is to assess hypoglycemia in a contemporaneous population of children with Type 1 diabetes using near continuous glucose monitoring. This will be an observational study in a home environment. Aim 4 is to assess the long-term effectiveness of near continuous glucose monitoring on decreasing the frequency and severity of hypoglycemic reactions, and improving glycemic control.

描述（由申请人编写）：研究者建议开发一种 评价儿童近连续葡萄糖传感器的系统方法 和青少年。这种方法可以用于评估当前的 传感器，现在提供给公众，并为未来的传感器， 在这个项目中可用。准确度将使用正常 对照组和糖尿病儿童。初始精度测量值为 使用葡萄糖的实验室质量测量在CRC中进行。的 然后将在家庭环境中评估传感器，以确定其 检测血糖水平变化和改善糖尿病的有用性 管理研究者将收集详细的进食记录， 并将使用一个 加速度计以及心理评估。这些数据将 综合评价导致低血糖的多种因素， 血糖水平的变化，以及提供有效的工具， 改善糖尿病管理。在未来，这些数据将是有价值的， 开发将这些信息整合到闭环中的算法 胰岛素输送系统。目标1是确定 正常儿童的近连续血糖监测仪。这将允许 评估可能的生理影响，如睡眠和身体 对葡萄糖水平的影响。这些研究还将有助于确定 探头读数在低血糖范围内的发生率， 血糖水平目的2是确定近连续的精度 糖尿病儿童的血糖传感器。将特别注意 低血糖症，尤其是夜间低血糖症的检测， 传感器在身体活动期间的准确性。目的3是评估低血糖 在同期的1型糖尿病儿童人群中， 连续血糖监测。这将是一项观察性研究， 环境目的4是评估近距离治疗的长期有效性。 持续血糖监测对降低 低血糖反应和改善血糖控制。