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Paediatric estimated average glucose in children with Type 1 diabetes
S M P O'Riordan1, T Danne, R Hanas
1Developmental Endocrinology Research Group, Clinical Molecular and Genetics Unit, Institute of Child Health, University College London, London, UK; Children and Young Persons Diabetes Service, University College London Hospitals, London, UK.
Summary
A new paediatric equation accurately estimates average glucose in children with Type 1 diabetes, offering a better measure of glycaemic control than the existing Nathan equation. This research validates a paediatric-specific formula for estimated average glucose.
Area of Science:
- Pediatric Endocrinology
- Diabetes Management
- Clinical Chemistry
Background:
- Estimated average glucose (eAG) is crucial for patient understanding of glycaemic control.
- Existing eAG equations were derived from adult data and require validation in pediatric populations.
- Continuous glucose monitoring (CGM) provides a direct measure of glucose levels.
Purpose of the Study:
- To develop and validate a paediatric-specific equation for estimated average glucose (eAG) in children and young people with Type 1 diabetes.
- To compare the performance of the new paediatric eAG equation with the established Nathan eAG equation.
- To assess the agreement between CGM-derived glucose and HbA1c in a pediatric cohort.
Main Methods:
- Cross-sectional study involving 234 children and young people (aged 4.0-23.5 years) with Type 1 diabetes.
- Collected data included continuous glucose monitoring (CGM) over 5 days and HbA1c measurements.
- Regression analysis was used to derive the paediatric eAG equation and assess agreement with the Nathan equation.
Main Results:
- The developed paediatric eAG equation is: eAG = 0.49 (HbA1c %) + 5.95 (r=0.45, P<0.001).
- Mean paediatric eAG was 10.4 (1.1) mmol/l, significantly lower than the Nathan eAG of 11.9 (3.7) mmol/l (P<0.001).
- Close agreement was observed between paediatric eAG and Nathan eAG for HbA1c values below 80 mmol/mol (9.5%).
Conclusions:
- The derived paediatric eAG equation shows promise for use in children and young people with Type 1 diabetes.
- While the Nathan equation may be applicable, caution is advised due to differing average HbA1c levels and data skew.
- Further evaluation is warranted to refine eAG estimates in pediatric diabetes management.
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