Glucose Sensors and Hypoglycemia in Children with DM

描述(申请人提供)：目前接受强化治疗 作为降低长期并发症风险的护理标准 所有年龄段的糖尿病患者。然而，强化治疗经常是 并发低血糖。与成人、年幼儿童和 青少年有更多的生活方式特征，这使他们容易患上 低血糖，然后成为一种危险的并发症和主要限制 强化治疗和良好的糖尿病控制的因素。现在的家 血糖监测能力很难准确定义 糖尿病儿童低血糖的发生率、持续时间和严重程度。 一种连续血糖监测系统(CGMS)最近已成为可用的 一种更密切地检查血糖模式的工具，最多可记录288 每天的血糖测量(72小时内的864个血糖读数)。这个 拟议研究的目的是阐明低血糖的程度和 影响儿童低血糖的相关因素 糖尿病。 在这项描述性研究中，将研究四个年龄段的儿童： 定义为2-6岁、6-10岁、10-14岁和14-18岁的儿童。按年龄分组 将确保对不同年龄的儿童进行适当的抽样，以及 大量的青春期前队列。18名患有糖尿病的儿童将被纳入 每个年龄段共72例糖尿病患者。九个孩子 没有糖尿病的人将作为各年龄段的对照，以便研究 正常的生理性血糖变异性。在四年的数据中 收集，受试者将参加一到三年，视情况而定 注册时间。他们将安装CGMS三天， 每季度、每周轮流和周末间隔。数据将在以下地址获得 S的病史、血糖水平、基因分型和饮食 入口处。活动将通过加速度计进行监测。认知功能， 学校的表现、行为和对糖尿病的适应情况将作为衡量标准 导致低血糖风险的潜在因素。综上所述，CGMS 将提供有关低血糖的有价值的信息 频率和严重性，以及与此严重相关的风险因素 儿童糖尿病强化治疗的并发症。

DESCRIPTION (provided by applicant): Intensive therapy is currently accepted as the standard of care to reduce the risk of long term complication in patients with diabetes of all ages. However, intensive therapy is frequently complicated by hypoglycemia. In comparison to adults, young children and adolescents have even more lifestyle characteristics that make them prone to hypoglycemia, which then becomes a dangerous complication and a major limiting factor of intensive treatment and good diabetes control. With current home glucose monitoring capabilities it is difficult to accurately define the true incidence, duration, and severity of hypoglycemia in children with diabetes. A continuous glucose monitoring system (CGMS) has recently become available as a tool to more closely examine blood glucose patterns, by recording up to 288 glucose measurements a day (864 glucose readings over a 72 hour period). The purpose of the proposed study is to elucidate the extent of hypoglycemia and the factors that contribute to hypoglycemia in children with and without diabetes. In this descriptive study, four age groups of children will be studied: defined by children 2-6, 6-10, 10-14, and 14-18 years of age. Grouping by age will assure an appropriate sample of children of different ages, as well as a large prepubertal cohort. Eighteen children with diabetes will be included in each age group for a total of 72 patients with diabetes. Nine children without diabetes will serve as controls for each age group in order to study the normal physiologic glucose variability. During the four years of data collection, subjects will participate for one to three years, depending on the time of enrollment. They will be fitted with the CGMS for three days, quarterly, alternating week, and weekend intervals. Data will be obtained on the child?s medical history, blood glucose levels, genotyping, and dietary intake. Activity will be monitored by accelerometry. Cognitive functioning, school performance, behavior, and adjustment to diabetes will be measured as potential factors contributing to the risk of hypoglycemia. In summary, CGMS in children with diabetes will provide valuable information on hypoglycemia frequency and severity, and the risk factors associated with this serious complication of intensive diabetes management in children.