Search

Background: Time in range is a reliable measure of the risk of diabetes complications. High percentage of patients with diabetes fail to achieve the recommended time in range (TIR) target of 70–180 mg/dl (3.9–10 mmol/l) >70%. Objective: This study aimed to identify factors influencing TIR prolongation. Methods: Children aged 1–17 years with >1-year type 1 diabetes (T1D) duration, treated with continuous subcutaneous insulin infusion (CSII) ≥3 months, using continuous glucose monitoring (CGM) or intermittently scanned CGM (is-CGM) ≥1 month, and with a registration time >70% were included. Data were collected during routine diabetology visits at an outpatient clinic. Insulin pump and CGM or is-CGM reports in the most recent 14 days were recorded using a dedicated software. Legal caregivers were also asked to complete a questionnaire on how the patients use the insulin pump functions and eating habits. Results: A sample of 110 patients was categorized into two groups: those with TIR >70% and TIR ≤70%. TIR ≤70% group presented with repeated hyperglycemia and a high glycemic variability coefficient of variation. We noted an acceptable hypoglycemia rate (3%), regardless of the TIR value. Patients with TIR >70% predominantly used predictive low glucose suspend system, maintained adequate intervals between insulin delivery and meal consumption, used the "bolus calculator" function, and more frequently created electronic reports. Conclusions: Hyperglycemia and high glycemic variability prevent patients from achieving the target TIR. Advanced features in the CGM systems, premeal insulin bolus, and patients' involvement in diabetes treatment are the main factors contributing to TIR prolongation. [ABSTRACT FROM AUTHOR]

A correction to the article "Factors affecting the prolongation of glycemic time in range among children with type 1 diabetes using continuous glucose monitoring systems: A case control study" that was published in a previous issue of the periodical, is presented.

Background: The study aimed to evaluate whether the presence of DKA at diabetes diagnosis was associated with poorer metabolic control during a 5-year follow-up. Methods: The study included children treated due to newly diagnosed T1D complicated with DKA between 2010 and 2014 with a complete 5-year follow-up. In every case we performed individual matching for age, gender and BMI with a person without DKA (nDKA) on recognition. We collected data regarding treatment modality, HbA1C, total daily insulin dose, basal insulin and BMI-SDS. Results: 85 children at the median age of 7.93 years had DKA at diabetes diagnosis. The median pH was 7.19.Continuous subcutaneous insulin infusion (CSII) was used in 87% of participants in each group. No differences in HbA1C level (7,3%vs7,2%;p =.413) were noted after 5 years of disease duration. The severity of ketoacidosis exerted no significant effect on HbA1C. The method of insulin delivery at baseline was significantly associated with HbA1C levels after 5 years of observation, βCSII = − 1.46,95%CI[− 2.01 to − 0.92],p <.001. Conclusions: The presence of DKA at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of DKA and lead to a long-term HbA1C improvement. [ABSTRACT FROM AUTHOR]