Objective: Children identified with stage
1 type 1 diabetes are at high risk for progressing to stage 3 (clinical) diabetes
and require accurate monitoring. Our aim was to establish CGM metrics that
could predict imminent progression to diabetes.
<p>Methods: In the Autoimmunity Screening
for Kids study, 91 children persistently islet autoantibody positive (median
age 11.5 y, 48% non-Hispanic White, 57% female) with a baseline CGM were
followed for development of diabetes for a median of 6 (range:0.2-34) months.
Of these, 16 (18%) progressed to clinical diabetes in a median of 4.5 (range:0.4-29
months. </p>
<p>Results: Compared to non-progressors,
progressors had significantly higher average sensor glucose (119 vs 105 mg/dL)
and increased glycemic variability: SD 27 vs 16, CV 21 vs 15, MODD 24 vs 16 and MAGE 43 vs 26. Progressors spent 21% of <a>time above 140 mg/dl </a>(TA140) and 8% above 160 mg/dl,
compared to 3% and 1%, respectively, for non-progressors. <a>In
survival analyses, the risk of progression to diabetes in one year was 80% in
those with TA140 >10%; in contrast, it was only 5% in the other
participants. </a><a>Performance of prediction by receiver
operating curve analyses showed area under the curve of <u>></u>0.89 for
both individual and combined CGM metric models</a>. </p>
<p>Conclusions<a>: </a><a>TA140 >10% is associated with a high risk of progression to
clinical diabetes within the next year</a> in
autoantibody positive children. CGM should be included in the ongoing monitoring of high-risk children<a></a><a>
a</a>nd could be used as potential entry criteria
for prevention trials. </p>