Early Dysglycemia Is Detectable Using Continuous Glucose Monitoring in Very Young Children at Risk of Type 1 Diabetes

Haynes, A; Tully, A; Smith, GJ; Penno, MAS; Craig, ME; Wentworth, JM; Huynh, T; Colman, PG; Soldatos, G; Anderson, AJ; McGorm, KJ; Oakey, H; Couper, JJ; Davis, EA

Author(s): Haynes, A; Tully, A; Smith, GJ; Penno, MAS; Craig, ME; Wentworth, JM; Huynh, T; Colman, PG; Soldatos, G; Anderson, AJ; McGorm, KJ; Oakey, H; Couper, JJ; Davis, EA;
Details: Publication Year 2024-07-30,Volume 47,Issue #10,Page 1750-1756
Journal Title: Diabetes Care
Abstract: OBJECTIVE: Continuous glucose monitoring (CGM) can detect early dysglycemia in older children and adults with presymptomatic type 1 diabetes (T1D) and predict risk of progression to clinical onset. However, CGM data for very young children at greatest risk of disease progression are lacking. This study aimed to investigate the use of CGM data measured in children being longitudinally observed in the Australian Environmental Determinants of Islet Autoimmunity (ENDIA) study from birth to age 10 years. RESEARCH DESIGN AND METHODS: Between January 2021 and June 2023, 31 ENDIA children with persistent multiple islet autoimmunity (PM Ab+) and 24 age-matched controls underwent CGM assessment alongside standard clinical monitoring. The CGM metrics of glucose SD (SDSGL), coefficient of variation (CEV), mean sensor glucose (SGL), and percentage of time >7.8 mmol/L (140 mg/dL) were determined and examined for between-group differences. RESULTS: The mean (SD) ages of PM Ab+ and Ab- children were 4.4 (1.8) and 4.7 (1.9) years, respectively. Eighty-six percent of eligible PM Ab+ children consented to CGM wear, achieving a median (quartile 1 [Q1], Q3) sensor wear period of 12.5 (9.0, 15.0) days. PM Ab+ children had higher median (Q1, Q3) SDSGL (1.1 [0.9, 1.3] vs. 0.9 [0.8, 1.0] mmol/L; P < 0.001) and CEV (17.3% [16.0, 20.9] vs. 14.7% [12.9, 16.6]; P < 0.001). Percentage of time >7.8 mmol/L was greater in PM Ab+ children (median [Q1, Q3] 8.0% [4.4, 13.0] compared with 3.3% [1.4, 5.3] in Ab- children; P = 0.005). Mean SGL did not differ significantly between groups (P = 0.10). CONCLUSIONS: CGM is feasible and well tolerated in very young children at risk of T1D. Very young PM Ab+ children have increased SDSGL, CEV, and percentage of time >7.8 mmol/L, consistent with prior studies involving older participants.
Publisher: American Diabetes Association
Keywords: Humans; *Diabetes Mellitus, Type 1/blood/diagnosis; Child, Preschool; Female; Male; Child; *Blood Glucose Self-Monitoring; *Blood Glucose/analysis; Infant; Infant, Newborn; Continuous Glucose Monitoring
Research Division(s): Population Health And Immunity
PubMed ID: 39159241
Publisher's Version: https://doi.org/10.2337/dc24-0540
Open Access at Publisher's Site: https://doi.org/10.2337/dc24-0540
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-08-23 02:54:05

Last Modified: 2024-10-03 09:19:51