Comparisons of School-Day Glycemia in Different Settings for Children with Type 1 Diabetes Using Continuous Glucose Monitoring

被引:0
作者
March, Christine A. [1 ]
Nanni, Michelle [2 ]
Lutz, James [3 ]
Kavanaugh, Madison [4 ]
Jeong, Kwonho [5 ]
Siminerio, Linda M. [6 ]
Rothenberger, Scott [5 ,6 ]
Miller, Elizabeth [1 ]
Libman, Ingrid M. [1 ]
机构
[1] Univ Pittsburgh, Dept Pediat, Pittsburgh, PA 15260 USA
[2] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA
[3] Univ Pittsburgh, Sch Arts & Sci, Pittsburgh, PA USA
[4] UPMC Childrens Hosp Pittsburgh, Dept Pediat, Pittsburgh, PA USA
[5] Univ Pittsburgh, Ctr Res Hlth Care Data Ctr, Pittsburgh, PA USA
[6] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA
关键词
type; 1; diabetes; school health; continuous glucose monitoring; time in range; glycemic control; YOUNG-CHILDREN; MANAGEMENT; ADOLESCENTS; ROUTINES; ADULTS; HEALTH; PARENT;
D O I
10.1155/2023/8176606
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. Using continuous glucose monitoring (CGM), we examined patterns in glycemia during school hours for children with type 1 diabetes, exploring diferences between school and nonschool time. Methods. We conducted a retrospective analysis of CGM metrics in children 7-12 years (n = 217, diabetes duration 3.5 +/- 2.5 years, hemoglobin A1c 7.5 +/- 0.8%). Metrics were obtained for weekday school hours (8 AM to 3 PM) during four weeks in fall 2019. Two comparison settings included weekend (fall 2019) and weekday (spring 2020) data when children had transitioned to virtual school due to COVID-19. We used multilevel mixed models to examine factors associated with time in range (TIR) and compare glycemia between in-school, weekends, and virtual school. Results. Tough CGM metrics were clinically similar across settings, TIR was statistically higher, and time above range (TAR), mean glucose, and standard deviation (SD) were lower, for weekends and virtual school (p < 0.001). Hour and setting exhibited a signifcant interaction for several metrics (p < 0.001). TIR in-school improved from a mean of 40.9% at the start of the school day to 58.0% later in school, with a corresponding decrease in TAR. TIR decreased on weekends (60.8 to 50.7%) and virtual school (62.2 to 47.8%) during the same interval. Mean glucose exhibited a similar pattern, though there was little change in SD. Younger age (p = 0.006), lower hemoglobin A1c (p < 0.001), and insulin pump use (p = 0.02) were associated with higher TIR in-school. Conclusion. Although TIR was higher for weekends and virtual school, glycemic metrics improve while in-school, possibly related to benefcial school day routines.
引用
收藏
页数:11
相关论文
共 33 条
[1]   A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Transatlantic Comparison [J].
Addala, Ananta ;
Auzanneau, Marie ;
Miller, Kellee ;
Maier, Werner ;
Foster, Nicole ;
Kapellen, Thomas ;
Walker, Ashby ;
Rosenbauer, Joachim ;
Maahs, David M. ;
Holl, Reinhard W. .
DIABETES CARE, 2021, 44 (01) :133-140
[2]   14. Children and Adolescents: Standards of Medical Care in Diabetes-2022 [J].
American Diabetes Association Professional Practice Committee .
DIABETES CARE, 2022, 45 :S208-S231
[3]   Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range [J].
Battelino, Tadej ;
Danne, Thomas ;
Bergenstal, Richard M. ;
Amiel, Stephanie A. ;
Beck, Roy ;
Biester, Torben ;
Bosi, Emanuele ;
Buckingham, Bruce A. ;
Cefalu, William T. ;
Close, Kelly L. ;
Cobelli, Claudio ;
Dassau, Eyal ;
DeVries, J. Hans ;
Donaghue, Kim C. ;
Dovc, Klemen ;
Doyle, Francis J. ;
Garg, Satish ;
Grunberger, George ;
Heller, Simon ;
Heinemann, Lutz ;
Hirsch, Irl B. ;
Hovorka, Roman ;
Jia, Weiping ;
Kordonouri, Olga ;
Kovatchev, Boris ;
Kowalski, Aaron ;
Laffel, Lori ;
Levine, Brian ;
Mayorov, Alexander ;
Mathieu, Chantal ;
Murphy, Helen R. ;
Nimri, Revital ;
Norgaard, Kirsten ;
Parkin, Christopher G. ;
Renard, Eric ;
Rodbard, David ;
Saboo, Banshi ;
Schatz, Desmond ;
Stoner, Keaton ;
Urakami, Tatsuiko ;
Weinzimer, Stuart A. ;
Phillip, Moshe .
DIABETES CARE, 2019, 42 (08) :1593-1603
[4]  
Beck Roy W, 2019, J Diabetes Sci Technol, V13, P614, DOI [10.1177/1932296818822496, 10.1177/1932296818822496]
[5]   A Randomized Trial of Closed-Loop Control in Children with Type 1 Diabetes [J].
Breton, Marc D. ;
Kanapka, Lauren G. ;
Beck, Roy W. ;
Ekhlaspour, Laya ;
Forlenza, Gregory P. ;
Cengiz, Eda ;
Schoelwer, Melissa ;
Ruedy, Katrina J. ;
Jost, Emily ;
Carria, Lori ;
Emory, Emma ;
Hsu, Liana J. ;
Oliveri, Mary ;
Kollman, Craig C. ;
Dokken, Betsy B. ;
Weinzimer, Stuart A. ;
DeBoer, Mark D. ;
Buckingham, Bruce A. ;
Chernavvsky, Daniel ;
Wadwa, R. Paul .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 383 (09) :836-845
[6]   Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes [J].
Brown, S. A. ;
Kovatchev, B. P. ;
Raghinaru, D. ;
Lum, J. W. ;
Buckingham, B. A. ;
Kudva, Y. C. ;
Laffel, L. M. ;
Levy, C. J. ;
Pinsker, J. E. ;
Wadwa, R. P. ;
Dassau, E. ;
Doyle, F. J., III ;
Anderson, S. M. ;
Church, M. M. ;
Dadlani, V ;
Ekhlaspour, L. ;
Forlenza, G. P. ;
Isganaitis, E. ;
Lam, D. W. ;
Kollman, C. ;
Beck, R. W. .
NEW ENGLAND JOURNAL OF MEDICINE, 2019, 381 (18) :1707-1717
[7]   Multicenter Trial of a Tubeless, On-Body Automated Insulin Delivery System With Customizable Glycemic Targets in Pediatric and Adult Participants With Type 1 Diabetes [J].
Brown, Sue A. ;
Forlenza, Gregory P. ;
Bode, Bruce W. ;
Pinsker, Jordan E. ;
Levy, Carol J. ;
Criego, Amy B. ;
Hansen, David W. ;
Hirsch, Irl B. ;
Carlson, Anders L. ;
Bergenstal, Richard M. ;
Sherr, Jennifer L. ;
Mehta, Sanjeev N. ;
Laffel, Lori M. ;
Shah, Viral N. ;
Bhargava, Anuj ;
Weinstock, Ruth S. ;
MacLeish, Sarah A. ;
DeSalvo, Daniel J. ;
Jones, Thomas C. ;
Aleppo, Grazia ;
Buckingham, Bruce A. ;
Ly, Trang T. .
DIABETES CARE, 2021, 44 (07) :1630-1640
[8]   Time in Range in Children with Type 1 Diabetes Using Treatment Strategies Based on Nonautomated Insulin Delivery Systems in the Real World [J].
Cherubini, Valentino ;
Bonfanti, Riccardo ;
Casertano, Alberto ;
De Nitto, Elena ;
Iannilli, Antonio ;
Lombardo, Fortunato ;
Maltoni, Giulio ;
Marigliano, Marco ;
Bassi, Marta ;
Minuto, Nicola ;
Mozzillo, Enza ;
Rabbone, Ivana ;
Rapini, Novella ;
Rigamonti, Andrea ;
Salzano, Giuseppina ;
Scaramuzza, Andrea ;
Schiaffini, Riccardo ;
Tinti, Davide ;
Toni, Sonia ;
Zagaroli, Luca ;
Zucchini, Stefano ;
Maffeis, Claudio ;
Gesuita, Rosaria .
DIABETES TECHNOLOGY & THERAPEUTICS, 2020, 22 (07) :509-515
[9]   Continuous glucose monitoring and glycemic control among youth with type 1 diabetes: International comparison from the T1D Exchange and DPV Initiative [J].
DeSalvo, Daniel J. ;
Miller, Kellee M. ;
Hermann, Julia M. ;
Maahs, David M. ;
Hofer, Sabine E. ;
Clements, Mark A. ;
Lilienthal, Eggert ;
Sherr, Jennifer L. ;
Tauschmann, Martin ;
Holl, Reinhard W. .
PEDIATRIC DIABETES, 2018, 19 (07) :1271-1275
[10]   Time spent outside of target glucose range for young children with type 1 diabetes: a continuous glucose monitor study [J].
DiMeglio, L. A. ;
Kanapka, L. G. ;
DeSalvo, D. J. ;
Anderson, B. J. ;
Harrington, K. R. ;
Hilliard, M. E. ;
Laffel, L. M. ;
Tamborlane, W., V ;
Van Name, M. A. ;
Wadwa, R. P. ;
Willi, S. M. ;
Woerner, S. ;
Wong, J. C. ;
Miller, K. M. .
DIABETIC MEDICINE, 2020, 37 (08) :1308-1315