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Exploring Minimally Invasive Approach to Define Stages of Type 1 Diabetes Remotely

Helena Kontola1, Inka Alanko1, Jaakko J Koskenniemi1,2

  • 1Department of Pediatrics, Turku University Hospital, Turku, Finland.

Diabetes Technology & Therapeutics
|June 2, 2022
PubMed

Insights

Continuous glucose monitoring (CGM) effectively detects stages of type 1 diabetes (T1D) in high-risk children. Combining CGM with home oral glucose tolerance tests (OGTT) offers a reliable method for monitoring and diagnosis.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pediatric Research

Background:

  • Accurate prediction and monitoring of type 1 diabetes (T1D) in high-risk children are crucial.
  • Continuous glucose monitoring (CGM) is valuable for T1D management, but its predictive utility requires further investigation.
  • Existing methods for T1D staging may have limitations in early detection.

Purpose of the Study:

  • To evaluate the accuracy of 10-day CGM and CGM during oral glucose tolerance tests (OGTT) in detecting stages of T1D.
  • To compare CGM performance in laboratory vs. home settings (home-OGTT).
  • To assess CGM's ability to identify asymptomatic and dysglycemic individuals at risk for T1D.

Main Methods:

  • Recruited 46 genetically at-risk children and adolescents (4-25 years) classified by islet autoantibody (IAb) status and T1D stage (0-3).
  • Utilized 10-day CGM prior to laboratory OGTT.
  • Compared CGM data with plasma glucose measurements during OGTT and analyzed 10-day CGM variables across T1D stages.

Main Results:

  • CGM demonstrated sensitivity in detecting asymptomatic (Stage 3) and dysglycemic (Stage 2) individuals with T1D.
  • Significant differences in CGM variables were observed during the 10-day monitoring period across different T1D stages.
  • CGM identified more abnormal OGTT results compared to plasma glucose alone and revealed distinct OGTT profiles.

Conclusions:

  • CGM, particularly when combined with home-OGTT, can accurately detect various stages of T1D in high-risk individuals.
  • This approach offers a valuable alternative for confirming normoglycemia and monitoring disease progression.
  • CGM enhances the ability to predict, monitor, and diagnose T1D in pediatric populations.

Keywords:
Continuous glucose monitoring (CGM)Impaired glucose metabolismIslet autoantibodiesOral glucose tolerance testPresymptomatic type 1 diabetesSelf-monitoringStages of type 1 diabetes (T1D) mellitus

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