Objective:

To assess glycemic variability according to the percentage coefficient of variation (%CV), the average amplitude of glycemic excursions (MAGE), and average daily differences (MODD), in a group of children, adolescents, and young adults with type 1 diabetes.

Methods:

Continuous glucose monitoring (CGM) was performed in 22 patients with type 1 diabetes. %CV, MAGE and MODD indices were calculated. The cut-off point for CV was 36% and60mg/dl for MODD, differentiating the patients with high glycemic variability from those with low variability. Comparisons according to demographic, clinical, and CGM tracing variables were made.

Results:

The 63.6% of the sample had a CV> 36% with an age average of 13.7 years old, lower average of glycemia, 157 mg/dl, higher percentage of hypoglycemia (12.9%), longer time in normal range (53.1%), and a greater number of glycemic excursions, especially downward. Mean MAGE value was 151 mg/dl, an inverse relationship being observed with the number of daily blood glucose tests performed, being smaller (128.5 mg/dl) in patients using insulin pumps. The 63.6% of the patients had a high MODD, they were diagnosed at a younger age and used a higher dose of insulin. No correlation was found between the studied indices and HbA1c.

Conclusion:

Patients with greater glycemic variability were older, had longer time in normal range, more frequent hypoglycemia, and a greater number of glycemic excursions. The CV, MAGE, and MODD indices as indicators of metabolic control provide risk data that are independent of HbA1c.

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