期刊
DIABETES CARE
卷 45, 期 2, 页码 365-371出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc21-0602
关键词
-
资金
- JDRF International [3-SRA-2018-564-M-N]
- The Leona M. and Harry B. Helmsley Charitable Trust
- Janssen Research and Development, LLC
Continuous glucose monitoring (CGM) metrics can be used to predict the risk of children with persistently positive islet autoantibodies progressing to clinical diabetes. Higher average sensor glucose levels and increased glycemic variability are predictive factors. Children with more than 10% of time spent with glucose levels above 140 mg/dL have a high risk of developing clinical diabetes within one year. CGM should be included in the monitoring of high-risk children and could be used as an entry criterion for prevention trials.
OBJECTIVE Children identified with stage 1 type 1 diabetes are at high risk for progressing to stage 3 (clinical) diabetes and require accurate monitoring. Our aim was to establish continuous glucose monitoring (CGM) metrics that could predict imminent progression to diabetes. RESEARCH DESIGN AND METHODS In the Autoimmunity Screening for Kids study, 91 children who were persistently islet autoantibody positive (median age 11.5 years; 48% non-Hispanic White; 57% female) with a baseline CGM were followed for development of diabetes for a median of 6 (range 0.2-34) months. Of these, 16 (18%) progressed to clinical diabetes in a median of 4.5 (range 0.4-29) months. RESULTS Compared with children who did not progress to clinical diabetes (nonprogressors), those who did (progressors) had significantly higher average sensor glucose levels (119 vs. 105 mg/dL, P < 0.001) and increased glycemic variability (SD 27 vs. 16, coefficient of variation, 21 vs. 15, mean of daily differences 24 vs. 16, and mean amplitude of glycemic excursions 43 vs. 26, all P < 0.001). For progressors, 21% of the time was spent with glucose levels > 140 mg/dL (TA140) and 8% of time > 160 mg/dL, compared with 3% and 1%, respectively, for nonprogressors. In survival analyses, the risk of progression to diabetes in 1 year was 80% in those with TA140 > 10%; in contrast, it was only 5% in the other participants. Performance of prediction by receiver operating curve analyses showed area under the curve of >= 0.89 for both individual and combined CGM metric models. CONCLUSIONS TA140 > 10% is associated with a high risk of progression to clinical diabetes within the next year in autoantibody-positive children. CGM should be included in the ongoing monitoring of high-risk children and could be used as potential entry criterion for prevention trials.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据