Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 7;34(5):619-625.
doi: 10.1515/jpem-2020-0725. Print 2021 May 26.

Exploring the inter-subject variability in the relationship between glucose monitoring metrics and glycated hemoglobin for pediatric patients with type 1 diabetes

Pietro Bosoni  1 , Valeria Calcaterra  2   3 , Valentina Tibollo  4 , Alberto Malovini  4 , Gianvincenzo Zuccotti  2   5 , Chiara Mameli  2   5 , Lucia Sacchi  1 , Riccardo Bellazzi  1   4 , Cristiana Larizza  1
Affiliations
Free article

Exploring the inter-subject variability in the relationship between glucose monitoring metrics and glycated hemoglobin for pediatric patients with type 1 diabetes

Pietro Bosoni et al. J Pediatr Endocrinol Metab. .
Free article

Abstract

Objectives: Despite the widespread diffusion of continuous glucose monitoring (CGM) systems, which includes both real-time CGM (rtCGM) and intermittently scanned CGM (isCGM), an effective application of CGM technology in clinical practice is still limited. The study aimed to investigate the relationship between isCGM-derived glycemic metrics and glycated hemoglobin (HbA1c), identifying overall CGM targets and exploring the inter-subject variability.

Methods: A group of 27 children and adolescents with type 1 diabetes under multiple daily injection insulin-therapy was enrolled. All participants used the isCGM Abbott's FreeStyle Libre system on average for eight months, and clinical data were collected from the Advanced Intelligent Distant-Glucose Monitoring platform. Starting from each HbA1c exam date, windows of past 30, 60, and 90 days were considered to compute several CGM metrics. The relationships between HbA1c and each metric were explored through linear mixed models, adopting an HbA1c target of 7%.

Results: Time in Range and Time in Target Range show a negative relationship with HbA1c (R2>0.88) whereas Time Above Range and Time Severely Above Range show a positive relationship (R2>0.75). Focusing on Time in Range in 30-day windows, random effect represented by the patient's specific intercept reveals a high variability compared to the overall population intercept.

Conclusions: This study confirms the relationship between several CGM metrics and HbA1c; it also highlights the importance of an individualized interpretation of the CGM data.

Keywords: HbA1c; children; continuous glucose monitoring; regression analysis; time in range; type 1 diabetes.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Patterson, CC, Karuranga, S, Salpea, P, Saeedi, P, Dahlquist, G, Soltesz, G, et al.. Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract 2019;157:107842.
    1. Nevo-Shenker, M, Phillip, M, Nimri, R, Shalitin, S. Type 1 diabetes mellitus management in young children: implementation of current technologies. Pediatr Res 2020;87:624–9.
    1. Neu, A, Bürger-Büsing, J, Danne, T, Dost, A, Holder, M, Holl, RW, et al.. Diagnosis, therapy and follow-up of diabetes mellitus in children and adolescents. Exp Clin Endocrinol Diabetes 2019;127:341–52.
    1. Braffett, BH, Gubitosi-Klug, RA, Albers, JW, Feldman, EL, Martin, CL, White, NH, et al.. Risk factors for diabetic peripheral neuropathy and cardiovascular autonomic neuropathy in the diabetes control and complications trial/epidemiology of diabetes interventions and complications (DCCT/EDIC) study. Diabetes 2020;69:1000–10.
    1. Bebu, I, Schade, D, Braffett, B, Kosiborod, M, Lopes-Virella, M, Soliman, EZ, et al.. Risk factors for first and subsequent CVD Events in type 1 diabetes: the DCCT/EDIC study. Diabetes Care 2020;43:867–74.

LinkOut - more resources