Comparisons of school-day glycemia in different settings for children with type 1 diabetes using continuous glucose monitoring.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
ACS Applied Electronic Materials Pub Date : 2023-01-01 Epub Date: 2023-03-09 DOI:10.1155/2023/8176606
Christine A March, Michelle Nanni, James Lutz, Madison Kavanaugh, Kwonho Jeong, Linda M Siminerio, Scott Rothenberger, Elizabeth Miller, Ingrid M Libman
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引用次数: 0

Abstract

Objective: Using continuous glucose monitoring (CGM), we examined patterns in glycemia during school hours for children with type 1 diabetes, exploring differences between school and non-school 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: Though CGM metrics were clinically similar across settings, TIR was statistically higher, and time above range (TAR), mean glucose, and standard deviation (SD) lower, for weekends and virtual school (p<0.001). Hour and setting exhibited a significant 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 beneficial school day routines.

应用连续血糖监测对1型糖尿病儿童不同环境下上学日血糖的比较
客观的使用连续血糖监测(CGM),我们检查了1型糖尿病儿童在上学时间的血糖模式,探讨了上学时间和非上学时间之间的差异。方法。我们对7-12岁儿童的CGM指标进行了回顾性分析 年(n = 217,糖尿病持续时间3.5 ± 2.5 年,血红蛋白A1c 7.5 ± 0.8%)。指标是针对2019年秋季四周的工作日上课时间(上午8点至下午3点)。两种比较设置包括周末(2019年秋季)和工作日(2020年春季)的数据,当时儿童因新冠肺炎过渡到虚拟学校。我们使用多水平混合模型来检查与范围内时间(TIR)相关的因素,并比较在校、周末和虚拟学校的血糖。后果尽管不同环境下的CGM指标在临床上相似,但在周末和虚拟学校,TIR在统计学上更高,高于范围的时间(TAR)、平均血糖和标准差(SD)更低(p<0.001)。小时和环境在几个指标上表现出显著的相互作用(p<0.001)。学校的TIR从开学时的平均40.9%提高到放学后的58.0%,TAR也相应下降。在同一时间段内,TIR在周末(60.8%至50.7%)和虚拟学校(62.2%至47.8%)下降。平均血糖表现出类似的模式,尽管SD几乎没有变化。年龄较小(p=0.006)、血红蛋白A1c较低(p<0.001)和使用胰岛素泵(p=0.02)与学校较高的TIR相关。结论尽管周末和虚拟学校的TIR更高,但在学校期间血糖指标有所改善,这可能与有益的学校日常生活有关。关键词:1型糖尿病,学校健康,持续血糖监测,范围内时间,血糖控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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