Glucose Profiles in Children Two Years After the Onset of Type 1 Diabetes

The relationship of 24‐h glucose profiles to age, haemoglobin A1c (HbA1c), and C‐peptide concentration was analysed in consecutive, unselected children who had developed Type 1 diabetes 2 years earlier. Seventy‐seven children in four age groups (age 2–4 years, n = 9; 5–8 years, n = 14; 9–12 years, n = 26; and 13–17 years, n = 28) were studied. Each child was hospitalized for 2 days for the investigations. Mean blood glucose concentration was 9.7 ± 4.1 (SD) mmol l−1 in children aged 2–4 years; 10.7 ± 4.0 mmol l−1 in those aged 5–8 years; 11.3 ± 3.4 mmol l−1 in those aged 9–12 years; and 9.8 ± 3.3 mmol l−1 in those aged 13–17 years. Results were > 7.0 mmol l−1 in 69% (range 56–76%) and > 10 mmol l−1 in 49% (39–57%) of the measurements. Values decreased by 30% (21–43%) between 10 pm and 3 am. The nadir of the mean profiles of the groups was always at 3 am. Glucose concentration was < 3.0 mmol l−1 in 25% (14–50%), < 2.5 mmol l−1 in 9.6% (0–21%), and < 2.0 mmol l−1 in 2.7% (0–4.2%) of the children at 3 am; hypoglycaemia was most common in those aged 5–8 years. Of the four profile characteristics used, mean blood glucose predicted HbA1c (R2 = 24.7%, p < 0.00005, multiple linear regression analysis), and slightly more in combination with age (R2 = 32.0%, p < 0.00005). The means, AUCs and coefficients of variation of the glucose profiles were not different in C‐peptide positive and C‐peptide negative children of the age groups (p = NS, two‐way ANOVA). We conclude that glucose profiles frequently uncover otherwise poorly recognizable disturbances of metabolic contol in children with diabetes.