Glycemia Risk Index Assessment in a Pediatric and Adult Patient Cohort With Type 1 Diabetes Mellitus.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Journal of Diabetes Science and Technology Pub Date : 2024-09-01 Epub Date: 2023-02-16 DOI:10.1177/19322968231154561

Gonzalo Díaz-Soto, Paloma Pérez-López, Pablo Férnandez-Velasco, María de la O Nieto de la Marca, Esther Delgado, Sofia Del Amo, Daniel de Luis, Pilar Bahillo-Curieses

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Abstract

Background: To evaluate the glycemia risk index (GRI) as a new glucometry in pediatric and adult populations with type 1 diabetes (T1D) in clinical practice.

Methods: A cross-sectional study of 202 patients with T1D receiving intensive treatment with insulin (25.2% continuous subcutaneous insulin infusion [CSII]) and intermittent scanning (flash) glucose monitoring (isCGM). Clinical and glucometric isCGM data were collected, as well as the component of hypoglycemia (CHypo) and component of hyperglycemia (CHyper) of the GRI.

Results: A total of 202 patients (53% males and 67.8% adults) with a mean age of 28.6 ± 15.7 years and 12.5 ± 10.9 years of T1D evolution were evaluated.Adult patients (>19 years) presented higher glycated hemoglobin (HbA1c) (7.4 ± 1.1 vs 6.7 ± 0.6%; P < .01) and lower time in range (TIR) (55.4 ± 17.5 vs 66.5 ± 13.1%; P < .01) values than the pediatric population, with lower coefficient of variation (CV) (38.6 ± 7.2 vs 42.4 ± 8.9%; P < .05). The GRI was significantly lower in pediatric patients (48.0 ± 22.2 vs 56.8 ± 23.4; P < .05) associated with higher CHypo (7.1 ± 5.1 vs 5.0 ± 4.5; P < .01) and lower CHyper (16.8 ± 9.8 vs 26.5 ± 15.1; P < .01) than in adults.When analyzing treatment with CSII compared with multiple doses of insulin (MDI), a nonsignificant trend to a lower GRI was observed in CSII (51.0 ± 15.3 vs 55.0 ± 25.4; P= .162), with higher levels of CHypo (6.5 ± 4.1 vs 5.4 ± 5.0; P < .01) and lower CHyper (19.6 ± 10.6 vs 24.6 ± 15.2; P < .05) compared with MDI.

Conclusions: In pediatric patients and in those with CSII treatment, despite a better control by classical and GRI parameters, higher overall CHypo was observed than in adults and MDI, respectively. The present study supports the usefulness of the GRI as a new glucometric parameter to evaluate the global risk of hypoglycemia-hyperglycemia in both pediatric and adult patients with T1D.

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1 型糖尿病儿童和成人患者队列中的血糖风险指数评估。

背景：评估血糖风险指数（GRI）作为一种新的血糖测量方法在儿童和成人 1 型糖尿病（T1D）患者中的临床应用：目的：评估血糖风险指数（GRI）作为一种新的血糖测量方法在1型糖尿病（T1D）儿童和成人临床实践中的应用：对 202 名接受胰岛素强化治疗（25.2% 持续皮下注射胰岛素 [CSII]）和间歇扫描（闪烁）血糖监测（isCGM）的 1 型糖尿病患者进行横断面研究。收集了 isCGM 的临床和血糖数据，以及 GRI 的低血糖成分（CHypo）和高血糖成分（CHyper）：共评估了 202 名患者（53% 为男性，67.8% 为成人），平均年龄（28.6 ± 15.7）岁，T1D 病程（12.5 ± 10.9）年。与儿科患者相比，成人患者（19 岁以上）的糖化血红蛋白 (HbA1c) 值更高（7.4 ± 1.1 vs 6.7 ± 0.6%；P < .01），范围内时间 (TIR) 值更低（55.4 ± 17.5 vs 66.5 ± 13.1%；P < .01），变异系数 (CV) 更低（38.6 ± 7.2 vs 42.4 ± 8.9%；P < .05）。与成人相比，儿科患者的 GRI 值明显较低（48.0 ± 22.2 vs 56.8 ± 23.4；P < .05），与较高的 CHypo 值（7.1 ± 5.1 vs 5.0 ± 4.5；P < .01）和较低的 CHyper 值（16.8 ± 9.8 vs 26.5 ± 15.1；P < .01）有关。在分析 CSII 与多剂量胰岛素 (MDI) 的治疗情况时，与 MDI 相比，CSII 的 GRI 呈不显著降低趋势（51.0 ± 15.3 vs 55.0 ± 25.4；P= .162），CHypo 水平较高（6.5 ± 4.1 vs 5.4 ± 5.0；P < .01），CHyper 水平较低（19.6 ± 10.6 vs 24.6 ± 15.2；P < .05）：在儿童患者和接受 CSII 治疗的患者中，尽管经典参数和 GRI 参数的控制效果更好，但观察到的总体 CHypo 分别高于成人和 MDI。本研究支持将 GRI 作为一种新的血糖测量参数，用于评估 T1D 儿童和成人患者发生低血糖-高血糖的总体风险。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.