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Huber, E. ; Singh, T. ; Bunk, M. ; Hebel, M. ; Kick, K.* ; Weiss, A. ; Kohls, M. ; Köger, M. ; Hergl, M. ; Zapardiel-Gonzalo, J. ; Bonifacio, E. ; Ziegler, A.-G.

Discrimination and precision of Continuous Glucose Monitoring in staging children with presymptomatic type 1 diabetes.

J. Clin. Endocrinol. Metab., DOI: 10.1210/clinem/dgae691 (2024)
Postprint DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
CONTEXT: Staging and monitoring of pre-symptomatic type 1 diabetes includes the assessment for dysglycemia. OBJECTIVE: To assess the ability of Continuous Glucose Monitoring (CGM) to differentiate between islet autoantibody-negative controls and early-stage type 1 diabetes and explore whether CGM classifiers predict progression to clinical diabetes. RESEARCH DESIGN AND METHODS: Children and adolescents participating in public health screening for islet autoantibodies in Bavaria, Germany were invited to undergo CGM with Dexcom G6. In total, 118 participated and valid data was obtained from 97 (57 female; median age 10 [range 3-17] years), including 46 with stage 1, 18 with stage 2, and 33 with no islet autoantibodies. RESULTS: Mean glucose during CGM in islet autoantibody-negative controls was high (median, 115.3 mg/dl) and varied substantially (IQR, 106.8-124.4). Eleven (33%) of the controls had more than 10% of glucose values above 140 mg/dl (TA140). Using thresholds corresponding to 100% specificity in controls, differences between controls and stage 1 and stage 2 were obtained for glucose standard deviation, TA140, TA160 and TA180. Elevations in any two of these parameters identified 12 (67%) with stage 2 and 9 (82%) of 11 participants who developed clinical diabetes within one year. However, there was marked variation within groups for all parameters and poor consistency observed in a second CGM performed in 18 participants. CONCLUSION: This study demonstrated the potential of integrating CGM into staging and monitoring of early-stage type 1 diabetes. However, substantial improvement in the precision of CGM is required for its application in routine monitoring practices.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Continuous Glucose Monitoring ; Disease Progression ; Early-stage Diagnosis ; Glucose Variability ; Pediatrics ; Type 1 Diabetes; Autoantibodies; Risk; Prediction; Accuracy; Elisa
ISSN (print) / ISBN 0021-972X
e-ISSN 1945-7197
Zeitschrift Journal of Clinical Endocrinology & Metabolism, The
Verlag Endocrine Society
Verlagsort Bethesda, Md.
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Diabetes Research Type 1 (IDF)
Institute for Pancreatic Beta Cell Research (IPI)
Förderungen Leona M and Harry B Helmsley Charitable Trust
Bavarian State Ministry of Health and Care (Gesund.Leben.Bayern)
Juvenile Diabetes Research Foundation International
LifeScience-Stiftung
Novo Nordisk
Deutscher Diabetiker Bund e.V.
German Center for Diabetes Research (DZD e.V.)