Achievement of target A1C levels with negligible hypoglycemia and low glucose variability in youth with short-term type 1 diabetes and residual β-cell function

Jennifer Sherr, William V. Tamborlane, Dongyuan Xing, Eva Tsalikian, Nelly Mauras, Bruce Buckingham, Neil H. White, Ana Maria Arbelaez, Roy W. Beck, Craig Kollman, Katrina Ruedy, Michael J. Tansey, Julie Coffey, Joanne Cabbage, Larry A. Fox, Kim Englert, Joe Permuy, Darrell M. Wilson, Paula Clinton, Kimberly CaswellStuart A. Weinzimer, Amy Steffen, Kate Weyman, Melinda Zgorski, Eileen Tichy, Lucy Levandoski, Angie Starnes, Beth Stevens, Gilman D. Grave, Karen K. Winer, Ellen Leschek, Mark Sperling, Dorothy M. Becker, Patricia Cleary, Carla Greenbaum, Antoinette Moran, Michael W. Steffes, Jean M. Bucksa, Maren L. Nowicki, Vicky Makky

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE - To determine exposure to hyper- and hypoglycemia using blinded continuous glucose monitoring (CGM) profiles in youth with type 1 diabetes (T1D) with residual β-cell function during the first year of insulin treatment. RESEARCH DESIGN AND METHODS - Blinded, 3-7 day CGMprofiles were obtained in 16 short-term T1D patients (age 8-18 years, T1D duration 6-52 weeks) who had peak C-peptide levels ranging from 0.46 to 1.96 nmol/L during a mixed-meal tolerance test. Results in this short-term group were compared with those in 34 patients with well-controlled, longer-term T1D (duration ≥5 years), matched for age and A1C with the short-term T1D group, and with those in 26 age-matched nondiabetic individuals. RESULTS - Despite matching for A1C, and therefore similar mean sensor glucose levels in the two T1D groups, short-term T1D participants had a lower frequency of hypoglycemia (0.3 vs. 7.6%, P < 0.001), a trend toward less hyperglycemia (17 vs. 32%, P = 0.15), and a greater percentage in the target range (median 77 vs. 60%, P = 0.02). Indeed, the percentage of sensor glucose levels ≤70 mg/dL in the short-term T1D group (0.3%) did not differ from those in the nondiabetic group (1.7%, P = 0.73). The coefficient of variation of sensor glucose levels (an index of glucose variability) was lower in short-term vs. longer-term T1D participants (27 vs. 42%, respectively, P < 0.001). CONCLUSIONS - In youth with short-term T1D who retain residual β-cell function, there is negligible exposure to hypoglycemia and lower glucose variability than in youth with well-controlled T1D of longer duration.

Original languageEnglish (US)
Pages (from-to)817-820
Number of pages4
JournalDiabetes care
Volume35
Issue number4
DOIs
StatePublished - Apr 1 2012

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    Sherr, J., Tamborlane, W. V., Xing, D., Tsalikian, E., Mauras, N., Buckingham, B., White, N. H., Arbelaez, A. M., Beck, R. W., Kollman, C., Ruedy, K., Tansey, M. J., Coffey, J., Cabbage, J., Fox, L. A., Englert, K., Permuy, J., Wilson, D. M., Clinton, P., ... Makky, V. (2012). Achievement of target A1C levels with negligible hypoglycemia and low glucose variability in youth with short-term type 1 diabetes and residual β-cell function. Diabetes care, 35(4), 817-820. https://doi.org/10.2337/dc11-2190