OBJECTIVE To evaluate glycemia and metrics of glucose variability in youth with type 1 diabetes, and to assess patterns of 24-h glucose variability according to pubertal status. RESEARCH DESIGN AND METHODS Metrics of glycemia, glucose variability, and glucose patterns were assessed by using 4 weeks of continuous glucose monitoring (CGM) data from 107 youth aged 8-17 years with type 1 diabetes for ≥1 year. Glucose values per hour were expressed as percentages relative to the mean glucose over 24 h for a 4-week period. Glucose data were compared on the basis of pubertal status-prepubertal (Tanner stage [T] 1), pubertal (T2-4), and postpubertal (T5)-and A1C categories (<7.5% [<58 mmol/mol], ≥7.5% [≥58 mmol/mol]). RESULTS Youth (50% female, 95% white) had a mean ± SD age of 13.1 ± 2.6 years, diabetes duration of 6.3 ± 3.5 years, and A1C of 7.8 ± 0.8% (62 ± 9 mmol/mol); 88% were pump treated. Prepubertal youth had a higher mean glucose SD (86 ± 12 mg/dL [4.8 ± 0.7 mmol/L]; P = 0.01) and coefficient of variation (CV) (43 ± 5%; P = 0.06) than did pubertal (SD 79 ± 13 mg/dL [4.4 ± 0.7 mmol/L]; CV 41 ± 5%) and postpubertal (SD 77 ± 14 mg/dL [4.3 ± 0.8 mmol/L]; CV 40 ± 5%) youth. Over 24 h, prepubertal youth had the largest excursions from mean glucose and the highest CV across most hours compared with pubertal and postpubertal youth. Across all youth, CV was strongly correlated with the percentage of time with glucose <70 mg/dL (<3.9 mmol/L) (r = 0.79; P < 0.0001). CONCLUSIONS Prepubertal youth had greater glucose variability independent of A1C than did pubertal and postpubertal youth. A1C alone does not capture the full range of glycemic parameters, highlighting the added insight of CGM in managing youth with type 1 diabetes.

中文翻译：

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1型糖尿病青年青春期状态的每日葡萄糖变异性的不同模式。

目的评估1型糖尿病青年的血糖和血糖变异性指标，并根据青春期状态评估24小时血糖变异性模式。研究设计和方法采用4周连续血糖监测（CGM）数据，对107位年龄在1-17岁以上且≥1年的青年进行了4周连续血糖监测（CGM）数据，评估了血糖，血糖变异性和血糖模式的指标。每小时葡萄糖值表示为相对于4周内24小时内平均葡萄糖的百分比。根据青春期状态-青春期前（Tanner阶段[T] 1），青春期（T2-4）和青春期（T5）-和A1C类别（<7.5％[<58 mmol / mol]，≥ 7.5％[≥58mmol / mol]。结果青年（女性50％，白人95％）的平均±SD年龄为13.1±2.6岁，糖尿病病程为6.3±3.5岁，A1C为7。8±0.8％（62±9 mmol / mol）; 88％的患者接受了泵治疗。青春期前青年的平均葡萄糖SD（86±12 mg / dL [4.8±0.7 mmol / L]； P = 0.01）和变异系数（CV）（43±5％; P = 0.06）比青春期（SD）高79±13 mg / dL [4.4±0.7 mmol / L]； CV 41±5％）和青春期后（SD 77±14 mg / dL [4.3±0.8 mmol / L]； CV 40±5％）的青年。在24小时内，与青春期和青春期后的年轻人相比，青春期前的年轻人在大多数小时内的平均葡萄糖偏移量最大，CV最高。在所有青年中，CV与葡萄糖<70 mg / dL（<3.9 mmol / L）的时间百分比密切相关（r = 0.79； P <0.0001）。结论青春期前的青年比青春期和青春期后的青年具有更大的葡萄糖变异性，而与A1C无关。单独使用A1C并不能捕获全部的血糖参数，