Time spent outside of target glucose range for young children with type 1 diabetes: a continuous glucose monitor study

Abstract

Aim: To assess the associations between demographic and clinical characteristics and sensor glucose metrics in young children with type 1 diabetes, using masked, continuous glucose monitoring data from children aged 2 to < 8 years.

Research design and methods: The analysis included 143 children across 14 sites in the USA, enrolled in a separate clinical trial. Eligibility criteria were: age 2 to <8 years; type 1 diabetes duration ≥3 months; no continuous glucose monitoring use for past 30 days; and HbA_1c concentration 53 to <86 mmol/mol (7.0 to <10.0%). All participants wore masked continuous glucose monitors up to 14 days.

Results: On average, participants spent the majority (13 h) of the day in hyperglycaemia (>10.0 mmol/l) and a median of ~1 h/day in hypoglycaemia (<3.9 mmol/l). Participants with minority race/ethnicity and higher parent education levels spent more time in target range, 3.9-10.0 mmol/l, and less time in hyperglycaemia. More time in hypoglycaemia was associated with minority race/ethnicity and younger age at diagnosis. Continuous glucose monitoring metrics were similar in pump and injection users.

Conclusions: Given that both hypo- and hyperglycaemia negatively impact neurocognitive development, strategies to increase time in target glucose range for young children are needed.

Trial registration: ClinicalTrials.gov NCT02912728.

FIGURE 1

Time in ranges based on glucose targets. (a) Time in target range (3.9–10.0 mmol/l) and time in hyperglycaemia (>10.0 and >13.9 mmol/l). (b) Time spent in hypoglycaemia (<3.9 and <3.0 mmol/l). Top and bottom portions of the boxes denote the 25^th and 75^th percentile, the line represents the median and the dot the mean. Whiskers represent the minimum and maximum after removing outliers.