Time in Range in Children with Type 1 Diabetes before and during a Diabetes Camp—A Ceiling Effect?
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Comparison Pre-Camp to Camp
3.2. Comparison of Day- and Nighttime
3.3. Insulin Dose Adjustments
3.4. Comparison between Insulin Pen and Pump Users
3.5. Comparison between rtCGM and isCGM Users
3.6. Associations with Improvement of TIR
3.7. Targets and Safety
4. Discussion
4.1. Improvement of Glycemic Control
4.2. Day and Night
4.3. Comparison of isCGM vs. rtCGM
4.4. Therapy Modalities
4.5. Diabetes Camp Effect
4.6. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All | Pen | Pump | p-Value | isCGM | rtCGM | p-Value | |
---|---|---|---|---|---|---|---|
N (%) | 26 | 10 (38.5%) | 16 (61.5%) | 13 (50%) | 13 (50%) | ||
Age (years) | 11.0 ± 1.4 | 11.4 ± 1.1 | 10.7 ± 1.5 | 0.24 | 11.1 ± 1.2 | 10.8 ± 1.6 | 0.58 |
female/male | 10/16 | 4/6 | 6/10 | 1.0 | 5/8 | 5/8 | 1.0 |
Diabetes duration (years) | 4.1 ± 3.1 | 3.0 ± 3.1 | 5.0 ± 2.9 | 0.11 | 4.2 ± 2.5 | 4.2 ± 3.6 | 0.95 |
Height (cm) | 145.9 ± 10.3 | 146.4 ± 9.8 | 145.7 ± 10.9 | 0.87 | 146.3 ± 8.1 | 145.5 ± 12.5 | 0.84 |
Height-SDS | −0.83 ± 0.97 | −0.46 ± 0.83 | 0.15 ± 1.00 | 0.12 | −0.13 ± 1.16 | −0.03 ± 0.79 | 0.79 |
Weight (kg) | 36.8 ± 7.63 | 35.4 ± 5.1 | 37.7 ± 8.9 | 0.41 | 38.5 ± 7.13 | 35.1 ± 8.0 | 0.265 |
BMI-SDS | −0.13 ± 0.98 | −0.53 ± 0.65 | 0.13 ± 1.07 | 0.09 | 0.17 ± 0.92 | −0.42 ± 0.97 | 0.127 |
HbA1c (%) | 7.3 ± 0.8 | 7.2 ± 1.1 | 7.3 ± 0.7 | 0.66 | 7.6 ± 0.8 | 7.0 ± 0.8 | 0.07 |
HbA1c (mmol/mol) | 56.3 ± 8.7 | 55.2 ± 12.0 | 56.3 ± 7.7 | 59.6 ± 8.7 | 53.0 ± 8.7 |
Difference between isCGM and rtCGM | Difference Pre-Camp to Camp | |||||||
---|---|---|---|---|---|---|---|---|
All | isCGM | rtCGM | p-Value | isCGM | rtCGM | |||
N | 26 | p-Value | 13 | 13 | p-Value | p-Value | ||
Time using CGM (%) | pre-camp | 95 [82;99] | 0.093 | 97 [71;100] | 94 [90;96] | 0.55 | 0.422 | 0.463 |
camp | 96 [92;97] | 97 [96;98] | 92 [86;96] | 0.006 | ||||
Time in range (TIR) | pre-camp | 58.2 ± 17.4 | 0.004 | 47.2 ± 12.2 | 69.1 ± 14.9 | <0.001 | 0.005 | 0.288 |
(%) | camp | 67.0 ± 10.7 | 62.1 ± 6.3 | 71.9 ± 12.2 | 0.019 | |||
Time below range | pre-camp | 3.2 ± 2.3 | <0.001 | 4.5 ± 2.4 | 1.8 ± 1.3 | 0.002 | 0.006 | 0.004 |
(TBR) (%) | camp | 5.5 ± 3.0 | 7.1 ± 2.7 | 3.8 ± 2.3 | 0.002 | |||
Time above range | pre-camp | 38.7 ± 16.9 | 0.001 | 48.3 ± 12.8 | 29.0 ± 15.0 | 0.002 | 0.002 | 0.109 |
(TAR) (%) | camp | 27.5 ± 10.2 | 30.7 ± 7.1 | 24.3 ± 12.1 | 0.114 | |||
Daytime TIR (%) | pre-camp | 55.5 ± 18.4 | 0.042 | 44.8 ± 12.9 | 66.2 ± 17.1 | 0.001 | 0.04 | 0.66 |
camp | 62.5 ± 12.8 | 57.4 ± 9.5 | 67.6 ± 13.9 | 0.040 | ||||
Nighttime TIR (%) | pre-camp | 62.5 ± 17.1 | <0.001 | 51.3 ± 13.4 | 73.8 ± 12.6 | <0.001 | <0.001 | 0.038 |
camp | 74.1 ± 10.3 | 69.7 ± 7.8 | 78.5 ± 10.8 | 0.027 | ||||
Daytime TBR (%) | pre-camp | 2.1 [1.0;4.0] | 0.038 | 2.3 [1.5;6.6] | 1.6 [0.8;2.5] | 0.86 | 0.507 | 0.009 |
camp | 3.2 [2.3;5.7] | 4.2 [2.5;5.8] | 2.9 [1.8;5.3] | 0.34 | ||||
Nighttime TBR (%) | pre-camp | 3.9 ± 3.2 | <0.001 | 5.9 ± 3.2 | 1.9 ± 1.5 | 0.001 | <0.001 | 0.017 |
camp | 7.6 ± 5 | 11.3 ± 3.9 | 3.9 ± 2.7 | <0.001 | ||||
Daytime TAR (%) | pre-camp | 41.7 ± 18.5 | 0.023 | 51.6 ± 14.2 | 31.9 ± 17.3 | 0.004 | 0.038 | 0.363 |
camp | 33.4 ± 13 | 38.0 ± 10.1 | 28.7 ± 14.3 | 0.07 | ||||
Nighttime TAR (%) | pre-camp | 33.6 ± 15.9 | <0.001 | 42.9 ± 13.5 | 24.3 ± 12.6 | 0.001 | <0.001 | 0.011 |
camp | 18.3 ± 9 | 19.0 ± 8.1 | 17.6 ± 10.0 | 0.7 | ||||
Total daily dose | pre-camp | 0.8 ± 0.2 | <0.001 | 0.85 ± 13.5 | 0.74 ± 18.1 | 0.08 | <0.001 | <0.001 |
(TDD) (IU/kg/d) | camp | 0.6 ± 0.1 | 0.70 ± 0.12 | 0.59 ± 0.13 | 0.027 | |||
Percentage of | pre-camp | 37.8 ± 9.7 | 0.040 | 40.4 ± 9.1 | 35.1 ± 9.9 | 0.16 | 0.526 | 0.011 |
basal Insulin (%) | camp | 40.3 ± 8.3 | 41.8 ± 5.6 | 38.9 ± 10.4 | 0.40 | |||
Daily intake of | pre-camp | 198.2 ± 30.9 | 0.003 | 212.7 ± 28.4 | 185.0 ± 28.02 | 0.022 | 0.07 | 0.026 |
carbohydrates (g) | camp | 180.2 ± 32.5 | 197.5 ± 27.2 | 166.7 ± 16.5 | 0.012 | |||
Scans per day | pre-camp | 13.1 ± 4.7 | 0.011 | . | . | . | . | . |
with isCGM | camp | 17.7 ± 4.5 | . | . | . | . | . | |
Difference TIR pre-camp to camp | (%) | 8.0 ± 14 | 15.0 ± 15.9 | 2.8 ± 9.0 | 0.025 | . | . | |
Difference TBR pre-camp to camp | (%) | 2 ± 2 | 2.6 ± 2.8 | 1.9 ± 1.9 | 0.47 | . | . | |
Difference TAR pre-camp to camp | (%) | −11 ± 15 | −17.6 ± 16.6 | −4.7 ± 9.8 | 0.024 | . | . | |
Difference TDD pre-camp to camp | (%) | −19.2 ± 9.9 | −17.1 ± 12.4 | −19.6 ± 9.8 | 0.56 | . | . |
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Nagl, K.; Bozic, I.; Berger, G.; Tauschmann, M.; Blauensteiner, N.; Weimann, K.; Mader, J.K.; Rami-Merhar, B. Time in Range in Children with Type 1 Diabetes before and during a Diabetes Camp—A Ceiling Effect? Children 2022, 9, 1951. https://doi.org/10.3390/children9121951
Nagl K, Bozic I, Berger G, Tauschmann M, Blauensteiner N, Weimann K, Mader JK, Rami-Merhar B. Time in Range in Children with Type 1 Diabetes before and during a Diabetes Camp—A Ceiling Effect? Children. 2022; 9(12):1951. https://doi.org/10.3390/children9121951
Chicago/Turabian StyleNagl, Katrin, Ina Bozic, Gabriele Berger, Martin Tauschmann, Nicole Blauensteiner, Katharina Weimann, Julia K. Mader, and Birgit Rami-Merhar. 2022. "Time in Range in Children with Type 1 Diabetes before and during a Diabetes Camp—A Ceiling Effect?" Children 9, no. 12: 1951. https://doi.org/10.3390/children9121951