ESPE Abstracts (2018) 89 FC12.1

Continuous Glucose Monitoring Profiles in Healthy Non-Diabetic Children and Adolescents: A Multicenter Prospective Study

Stephanie DuBosea, Zoey Lia, Roy Becka & William Tamborlaneb

aJaeb Center for Health Research, Tampa, Florida, USA; bYale School of Medicine, New Haven, Connecticut, USA

Since CGM-based outcomes that are increasingly being used in clinical pediatric diabetes research, this study was aimed at gathering normative sensor data in healthy, non-diabetic children using the recently approved DexCom G6 system. In this multicenter study, healthy, non-diabetic children and adolescents (age 7 to <18 years, BMI between 5th and 85th percentile, and HbA1c <5.7%) were included. Each participant wore a blinded DexCom G6 for approx. 10 days and kept a daily log of exercise, meals, and sleep. Only participants with no positive islet antibodies and ≥72 h of CGM data were analyzed, overall and by age group. Among the 56 healthy non-diabetic participants who were analyzed, 54% were female, 93% non-Hispanic White, mean HbA1c was 5.1% and mean BMI percentile was 51%. Overall mean 24-h sensor glucose level was 99±6 mg/dl. Peak post-prandial glucose was 126 mg/dl. Overall, meal-related increases in sensor glucose resulted in daytime glucose levels 3 mg/dl higher than nighttime values. Sensor glucose levels >120 and <70 mg/dl were not uncommon in either age group but sensor values >180 and <54 mg/dl were rarely observed (Table). As greater emphasis is placed on glycemic metrics beyond HbA1c levels, the current study provides a normative set of sensor glucose levels that can be used for comparison for clinical trials. It is noteworthy that sensor glucose levels >180 and <54 mg/dl were very uncommon in our healthy non-diabetic participants, which support these levels as the thresholds for clinically important hyper- and hypoglycemia in diabetes. With improvements in both pharmacologic agents and mechanical solutions the ultimate goal may be to attain tighter glycemic control in those living with diabetes by altering the hyperglycemic threshold to 160 mg/dl.

Table. Sensor glucose levels in healthy non-diabetic children and adolescents (n=56).
All (n=56)7–11 years old (n=26)12–17 years old (n=30)
Mean glucose (mg/dl)999998
Glucose CV - mean (%)15%16%15%
%Time in range 70–120 mg/dl89%89%91%
%Time >120 mg/dl7.4%8.4%7.0%
%Time >140 mg/dl1.3%1.7%1.2%
%Time >160 mg/dl0.2%0.2%0.2%
%Time >180 mg/dl0.0%0.0%0.0%
%Time <70 mg/dl1.3%1.0%1.7%
%Time <60 mg/dl0.2%0.2%0.2%
%Time <54 mg/dl0.0%0.0%0.0%
*All data are median unless otherwise noted.

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