Abstract
INTRODUCTION Effective diabetes mellitus management requires to maintain blood glucose levels in a narrow range between hyperglycemia causing late complications, and danger of severe hypoglycemia. This objective may be difficult to achieve especially in small children. THE AIM OF THE STUDY Evaluation of daily glycemic profiles obtained using a continuous glucose monitoring system in well controlled children with type 1 diabetes mellitus. MATERIAL AND METHODS In 32 children (19 boys), aged 8.34+/-3.38 years, with a good metabolic control (HbA1c=6.59+/-0.66%), T1DM duration of 3.76+/-2.2 years, and daily insulin requirement of 0.69+/-0.2 U/kg, the Medtronic Guardian RT device was applied for 2.92+/-0.61 days. The data analysis performed in periods of day (7:00-22:00), night (22:00-7:00) and full recording consisted of following parameters: mean (mG) and standard deviation of glucose (sdG), excursion duration times (t) and mean glucose in following excursions (mGex): hyperglycemias >160 and >135 mg/dL (8.9 and 7.5 mmol/L), and hypoglycemias <55 and <70 mg/dL (3 and 3.9 mmol/L). RESULTS The analyzed parameters did not vary between periods of day, night and full recording. For full recording values were: mG=120.9 mg/dL (6.72 mmol/L), sdG=39.73 mg/dL (2.18 mmol/L), t>135=32.04%, t>160=17.29%, mGex>135=169,78 mg/dL (9.43 mmol/L), mGex>160=189.2 mg/dL (10.51 mmol/L), t<55=0.91%, t<70=8.78%, Gex<55=51.99 mg/dL (2.89 mmol/L), mGex<70=63.18 mg/dL (3.51 mmol/L). The correlation coefficient values between HbA1c level and calculated parameters were the highest for full recording: mG r=0.44 (p<0.02), t>135 r=0.49 (p=0.005), t>160 r=0.45 (p=0.01), mGex>135 r=0.49 (p=0.005), mGex>160 r=0.47 (p<0.01). No significant correlations between the number of calibrations per day (6.62+/-2.53), and mG, t>135 and t>160 were found. CONCLUSIONS Continuous glucose monitoring showed almost-physiological glycemic profiles in well controlled children. Glycemic excursions times were very short.
