Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes

Abstract Aims/Introduction Coefficient of variation (CV) is an indicator for glucose variability in continuous glucose monitoring (CGM), and the target threshold of %CV in type 1 diabetes is proposed to be ≤36%. This study aimed to evaluate the clinical significance of CV in children and adolescents...

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Main Authors: Tatsuhiko Urakami, Hiroki Terada, Satomi Tanabe, Yusuke Mine, Masako Aoki, Ryoji Aoki, Junichi Suzuki, Ichiro Morioka
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:Journal of Diabetes Investigation
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Online Access:https://doi.org/10.1111/jdi.14303
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author Tatsuhiko Urakami
Hiroki Terada
Satomi Tanabe
Yusuke Mine
Masako Aoki
Ryoji Aoki
Junichi Suzuki
Ichiro Morioka
author_facet Tatsuhiko Urakami
Hiroki Terada
Satomi Tanabe
Yusuke Mine
Masako Aoki
Ryoji Aoki
Junichi Suzuki
Ichiro Morioka
author_sort Tatsuhiko Urakami
collection DOAJ
description Abstract Aims/Introduction Coefficient of variation (CV) is an indicator for glucose variability in continuous glucose monitoring (CGM), and the target threshold of %CV in type 1 diabetes is proposed to be ≤36%. This study aimed to evaluate the clinical significance of CV in children and adolescents with type 1 diabetes. Materials and Methods Participants included 66 children with type 1 diabetes. A total of 48 participants were treated with multiple daily injections of insulin, and 18 with continues subcutaneous insulin infusion, using intermittently scanned CGM. The frequencies of the CGM metrics and glycosylated hemoglobin values were examined, and the significance of a threshold %CV of 36% was evaluated. Results The mean frequencies in time in range (TIR), time below range, %CV and the mean glycosylated hemoglobin value were 59.3 ± 16.1, 4.0 ± 3.5, 39.3 ± 6.2 and 7.3 ± 0.8%, respectively. The frequencies of participants who achieved a TIR >70% and a %CV of ≤36% were 24.1 and 27.3%, respectively. A total of 18 participants with a %CV of ≤36% had significantly higher TIR, lower time below range and lower glycosylated hemoglobin than the 48 with a %CV of >36% (72.6 ± 12.6 vs 52.4 ± 13.6, 2.4 ± 1.9 vs 4.6 ± 3.6, 6.9 ± 0.8 vs 7.4 ± 0.7%, respectively). Conclusions Children and adolescents with type 1 diabetes using intermittently scanned CGM had difficulties in achieving the recommended targets of TIR and CV. However, the target %CV of ≤36% seems to be an appropriate indicator for assessing glycemic control and risk of hypoglycemia in pediatric patients with type 1 diabetes with any treatment.
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spelling doaj-art-9718bc17fec541b58986e4f4e8a1fdd32025-08-20T01:47:25ZengWileyJournal of Diabetes Investigation2040-11162040-11242024-11-0115111669167410.1111/jdi.14303Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetesTatsuhiko Urakami0Hiroki Terada1Satomi Tanabe2Yusuke Mine3Masako Aoki4Ryoji Aoki5Junichi Suzuki6Ichiro Morioka7Department of Pediatrics and Child Health Nihon University School of Medicine Tokyo JapanDepartment of Pediatrics and Child Health Nihon University School of Medicine Tokyo JapanDepartment of Pediatrics and Child Health Nihon University School of Medicine Tokyo JapanDepartment of Pediatrics and Child Health Nihon University School of Medicine Tokyo JapanDepartment of Pediatrics and Child Health Nihon University School of Medicine Tokyo JapanDepartment of Pediatrics and Child Health Nihon University School of Medicine Tokyo JapanDepartment of Pediatrics and Child Health Nihon University School of Medicine Tokyo JapanDepartment of Pediatrics and Child Health Nihon University School of Medicine Tokyo JapanAbstract Aims/Introduction Coefficient of variation (CV) is an indicator for glucose variability in continuous glucose monitoring (CGM), and the target threshold of %CV in type 1 diabetes is proposed to be ≤36%. This study aimed to evaluate the clinical significance of CV in children and adolescents with type 1 diabetes. Materials and Methods Participants included 66 children with type 1 diabetes. A total of 48 participants were treated with multiple daily injections of insulin, and 18 with continues subcutaneous insulin infusion, using intermittently scanned CGM. The frequencies of the CGM metrics and glycosylated hemoglobin values were examined, and the significance of a threshold %CV of 36% was evaluated. Results The mean frequencies in time in range (TIR), time below range, %CV and the mean glycosylated hemoglobin value were 59.3 ± 16.1, 4.0 ± 3.5, 39.3 ± 6.2 and 7.3 ± 0.8%, respectively. The frequencies of participants who achieved a TIR >70% and a %CV of ≤36% were 24.1 and 27.3%, respectively. A total of 18 participants with a %CV of ≤36% had significantly higher TIR, lower time below range and lower glycosylated hemoglobin than the 48 with a %CV of >36% (72.6 ± 12.6 vs 52.4 ± 13.6, 2.4 ± 1.9 vs 4.6 ± 3.6, 6.9 ± 0.8 vs 7.4 ± 0.7%, respectively). Conclusions Children and adolescents with type 1 diabetes using intermittently scanned CGM had difficulties in achieving the recommended targets of TIR and CV. However, the target %CV of ≤36% seems to be an appropriate indicator for assessing glycemic control and risk of hypoglycemia in pediatric patients with type 1 diabetes with any treatment.https://doi.org/10.1111/jdi.14303Children and adolescentsCoefficient of variationContinuous glucose monitoring
spellingShingle Tatsuhiko Urakami
Hiroki Terada
Satomi Tanabe
Yusuke Mine
Masako Aoki
Ryoji Aoki
Junichi Suzuki
Ichiro Morioka
Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes
Journal of Diabetes Investigation
Children and adolescents
Coefficient of variation
Continuous glucose monitoring
title Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes
title_full Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes
title_fullStr Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes
title_full_unstemmed Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes
title_short Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes
title_sort clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes
topic Children and adolescents
Coefficient of variation
Continuous glucose monitoring
url https://doi.org/10.1111/jdi.14303
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