Objectives: Primary aim of the study was to evaluate the effect of a single iPro2 CGM on 3-months. HbA1c. Secondary aims were the feasibility of iPro2 monitoring and the evaluation of different metabolic and risk indexes. Methods: Seventy pts with T1DM (age 13.8 ± 4.6 years, T1DM duration 7.4 ± 3.6 years, HbA1c 8.4% ± 1.3) treated with three different insulin regimens (three inj of premix ins. n = 6, MDI n = 45, CSII n = 19) wore iPro2 for 6 days. iPro2 was applied in pts with HbA1c >7% (n.59) despite optimized therapy, or with recurrent hypoglycemia and HbA1c <7% (n.11). HbA1c was tested before and 3 months. after CGM data were used for glucose variability (GV) indexes calculation (CV, Conga, MAGE, MODD, AUC) and glycemic risk (GR) assessment (LBGI, HBGI, BGRI, J index, ADRR and BG Rate). LBGI and HBGI were also tested for correlation with baseline (BL) parameters (HbA1c, age, BMI, pubertal stage, disease duration, therapeutic regimen). Results: No pts reported significant side effects. Three-month HbA1c decreased to 8.0% ± 1.0 (P = 0.04). In the pts with HbA1c >7% (n.51) HbA1c decreased from 8.8% ± 1.2 to 8.3% ± 0.94 (P = 0.008), while in the pts with HbA1c <7% (n.12) was unchanged 6.5% ± 0.4 of 6.7% ± 0.4 (NS). HBGI and LBGI didn’t significantly correlate with any BL parameter both in the univariate and multivariate logistic regression analysis. GV indexes were evaluated in pts with HbA1c increasing (n = 23, from 7.6 ± 1.1 to 8.1 ± 1.2) and decreasing (n = 47, from 8.8 ± 1.3 to 7.9 ± 0.9) founding no differences. Furthermore no significant differences were found between the therapy groups in GV indexes. Conclusions: iPro2 is feasible in pediatric patients and was helpful in improving HbA1c especially in patients with suboptimal glicemic control. No significant correlation was found between BL characteristics of pts and GR indexes (HBGI and LBGI). Since no significant difference was found considering HbA1c increasing and decreasing trend, it is confirmed the independent value of GV indexes in the assessment of metabolic control.
Usefulness of CGM with iPro2 in children with T1DM and correlations between Glucose Variability and metabolic control / Zucchini, Stefano; Scipione, M; Predieri, Barbara; Iughetti, Lorenzo; Balsamo, C; Rollo, A; Bruzzi, Patrizia; Molinari, E; Di Stefano, P; Maltoni, Giulio. - In: PEDIATRIC DIABETES. - ISSN 1399-5448. - STAMPA. - 13 (Suppl. 17):(2012), pp. 118-118. (Intervento presentato al convegno The 38th Annual Meeting of the International Society for Pediatric and Adolescent Diabetes (ISPAD) tenutosi a Istanbul, Turkey nel 10-13 October 2012).
Usefulness of CGM with iPro2 in children with T1DM and correlations between Glucose Variability and metabolic control
PREDIERI, Barbara;IUGHETTI, Lorenzo;BRUZZI, Patrizia;
2012
Abstract
Objectives: Primary aim of the study was to evaluate the effect of a single iPro2 CGM on 3-months. HbA1c. Secondary aims were the feasibility of iPro2 monitoring and the evaluation of different metabolic and risk indexes. Methods: Seventy pts with T1DM (age 13.8 ± 4.6 years, T1DM duration 7.4 ± 3.6 years, HbA1c 8.4% ± 1.3) treated with three different insulin regimens (three inj of premix ins. n = 6, MDI n = 45, CSII n = 19) wore iPro2 for 6 days. iPro2 was applied in pts with HbA1c >7% (n.59) despite optimized therapy, or with recurrent hypoglycemia and HbA1c <7% (n.11). HbA1c was tested before and 3 months. after CGM data were used for glucose variability (GV) indexes calculation (CV, Conga, MAGE, MODD, AUC) and glycemic risk (GR) assessment (LBGI, HBGI, BGRI, J index, ADRR and BG Rate). LBGI and HBGI were also tested for correlation with baseline (BL) parameters (HbA1c, age, BMI, pubertal stage, disease duration, therapeutic regimen). Results: No pts reported significant side effects. Three-month HbA1c decreased to 8.0% ± 1.0 (P = 0.04). In the pts with HbA1c >7% (n.51) HbA1c decreased from 8.8% ± 1.2 to 8.3% ± 0.94 (P = 0.008), while in the pts with HbA1c <7% (n.12) was unchanged 6.5% ± 0.4 of 6.7% ± 0.4 (NS). HBGI and LBGI didn’t significantly correlate with any BL parameter both in the univariate and multivariate logistic regression analysis. GV indexes were evaluated in pts with HbA1c increasing (n = 23, from 7.6 ± 1.1 to 8.1 ± 1.2) and decreasing (n = 47, from 8.8 ± 1.3 to 7.9 ± 0.9) founding no differences. Furthermore no significant differences were found between the therapy groups in GV indexes. Conclusions: iPro2 is feasible in pediatric patients and was helpful in improving HbA1c especially in patients with suboptimal glicemic control. No significant correlation was found between BL characteristics of pts and GR indexes (HBGI and LBGI). Since no significant difference was found considering HbA1c increasing and decreasing trend, it is confirmed the independent value of GV indexes in the assessment of metabolic control.
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