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Impact of Real-Time Continuous Glucose Monitoring Use on Glucose Variability and Endothelial Function in Adolescents with Type 1 Diabetes: New Technology--New Possibility to Decrease Cardiovascular Risk?

Jamiołkowska M, Jamiołkowska I, Łuczyński W, Tołwińska J, Bossowski A, Głowińska Olszewska B - J Diabetes Res (2015)

Bottom Line: In the whole group, FMD improvement was found (10.9% to 16.6%, p < 0.005), together with decrease in all studied glycaemic variability parameters.In patients with HbA1c improvement compared to the group without HbA1c improvement, we found greater increase of FMD (12% to 19%, p < 0.005 versus 8.2% to 11.3%, p = 0.080) and greater improvement of glucose variability.Whether such approach might influence improvement in endothelial function and reduction of the risk of future cardiovascular disease remains to be elucidated.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Subdivision, Medical University of Białystok, Jana Kilinskiego 1, 15-089 Białystok, Poland.

ABSTRACT
Children with type 1 diabetes (T1DM) are the high-risk group of accelerated atherosclerosis. Real-time continuous glucose monitoring (RT-CGM) provides possibilities for the detection of glycaemic variability, newly recognized cardiovascular risk factor. The aim of the study was to assess the usefulness of RT-CGM as an educational tool to find and reduce glycaemic variability in order to improve endothelial function in T1DM adolescents. Forty patients aged 14.6 years were recruited. The study was based on one-month CGM sensors use. Parameters of glycaemic variability were analyzed during first and last sensor use, together with brachial artery flow-mediated dilatation (FMD) to assess endothelial function. In the whole group, FMD improvement was found (10.9% to 16.6%, p < 0.005), together with decrease in all studied glycaemic variability parameters. In patients with HbA1c improvement compared to the group without HbA1c improvement, we found greater increase of FMD (12% to 19%, p < 0.005 versus 8.2% to 11.3%, p = 0.080) and greater improvement of glucose variability. RT-CGM can be considered as an additional tool that offers T1DM adolescents the quick reaction to decrease glycaemic variability in short time observation. Whether such approach might influence improvement in endothelial function and reduction of the risk of future cardiovascular disease remains to be elucidated.

No MeSH data available.


Related in: MedlinePlus

FMD in the whole study group before and after the study (data presented as mean ± SD).
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fig1: FMD in the whole study group before and after the study (data presented as mean ± SD).

Mentions: In the whole study group, an increase of FMD of the brachial artery was observed (from 10.90 ± 6.6% to 16.67 ± 8.5%, p < 0.005) (Figure 1). This result depended on metabolic control improvement. A much greater increase of FMD was found in the patients with HbA1c improvement (from 12.22 ± 5.4% to 19.27 ± 7.4%, p < 0.005) compared to the group without HbA1c improvement (from 8.18 ± 8.2% to 11.29 ± 8.4%, p = 0.080) (Figure 2). As we have subdivided our patients into two groups depending on the initial HbA1c level (>7.5% and <7.5%), we have found a greater increase of mean brachial artery FMD in a group with initial HbA1c below 7.5% (from 16.25 ± 4.3% to 27.81 ± 6.5%, p < 0.005) than in a group with initial HbA1c above 7.5% (from 9.57 ± 6.4% to 13.89 ± 6.4%, p < 0.005).


Impact of Real-Time Continuous Glucose Monitoring Use on Glucose Variability and Endothelial Function in Adolescents with Type 1 Diabetes: New Technology--New Possibility to Decrease Cardiovascular Risk?

Jamiołkowska M, Jamiołkowska I, Łuczyński W, Tołwińska J, Bossowski A, Głowińska Olszewska B - J Diabetes Res (2015)

FMD in the whole study group before and after the study (data presented as mean ± SD).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4663349&req=5

fig1: FMD in the whole study group before and after the study (data presented as mean ± SD).
Mentions: In the whole study group, an increase of FMD of the brachial artery was observed (from 10.90 ± 6.6% to 16.67 ± 8.5%, p < 0.005) (Figure 1). This result depended on metabolic control improvement. A much greater increase of FMD was found in the patients with HbA1c improvement (from 12.22 ± 5.4% to 19.27 ± 7.4%, p < 0.005) compared to the group without HbA1c improvement (from 8.18 ± 8.2% to 11.29 ± 8.4%, p = 0.080) (Figure 2). As we have subdivided our patients into two groups depending on the initial HbA1c level (>7.5% and <7.5%), we have found a greater increase of mean brachial artery FMD in a group with initial HbA1c below 7.5% (from 16.25 ± 4.3% to 27.81 ± 6.5%, p < 0.005) than in a group with initial HbA1c above 7.5% (from 9.57 ± 6.4% to 13.89 ± 6.4%, p < 0.005).

Bottom Line: In the whole group, FMD improvement was found (10.9% to 16.6%, p < 0.005), together with decrease in all studied glycaemic variability parameters.In patients with HbA1c improvement compared to the group without HbA1c improvement, we found greater increase of FMD (12% to 19%, p < 0.005 versus 8.2% to 11.3%, p = 0.080) and greater improvement of glucose variability.Whether such approach might influence improvement in endothelial function and reduction of the risk of future cardiovascular disease remains to be elucidated.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Subdivision, Medical University of Białystok, Jana Kilinskiego 1, 15-089 Białystok, Poland.

ABSTRACT
Children with type 1 diabetes (T1DM) are the high-risk group of accelerated atherosclerosis. Real-time continuous glucose monitoring (RT-CGM) provides possibilities for the detection of glycaemic variability, newly recognized cardiovascular risk factor. The aim of the study was to assess the usefulness of RT-CGM as an educational tool to find and reduce glycaemic variability in order to improve endothelial function in T1DM adolescents. Forty patients aged 14.6 years were recruited. The study was based on one-month CGM sensors use. Parameters of glycaemic variability were analyzed during first and last sensor use, together with brachial artery flow-mediated dilatation (FMD) to assess endothelial function. In the whole group, FMD improvement was found (10.9% to 16.6%, p < 0.005), together with decrease in all studied glycaemic variability parameters. In patients with HbA1c improvement compared to the group without HbA1c improvement, we found greater increase of FMD (12% to 19%, p < 0.005 versus 8.2% to 11.3%, p = 0.080) and greater improvement of glucose variability. RT-CGM can be considered as an additional tool that offers T1DM adolescents the quick reaction to decrease glycaemic variability in short time observation. Whether such approach might influence improvement in endothelial function and reduction of the risk of future cardiovascular disease remains to be elucidated.

No MeSH data available.


Related in: MedlinePlus