Masked hypertension and its associations with glycemic variability metrics in children and adolescents with type 1 diabetes

Homhuan, Warinpapha; Poomthavorn, Preamrudee; Paksi, Witchuri; Khlairit, Patcharin; Nongnuch, Arkom; Pirojsakul, Kwanchai

doi:10.1007/s00467-020-04720-2

Cited by 8 publications

(7 citation statements)

References 23 publications

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“…Not all studies provided details regarding the methodologies used and the populations studied. Of the 13 included studies, 7 studies [ 21 , 23 , 25 , 27 , 29 , 31 , 32 ] (54%) reported the same CGM methodology for GV assessment despite heterogeneity in the monitoring period (ranging from 48 h to 7 days). One study used the DexCom G4 Platinum technology [ 28 ] whereas seven studies used Medtronic glucose sensors [ 21 , 23 , 25 , 27 , 29 , 31 , 32 ].…”

Section: Presentation Of the Resultsmentioning

confidence: 99%

“…Of the 13 included studies, 7 studies [ 21 , 23 , 25 , 27 , 29 , 31 , 32 ] (54%) reported the same CGM methodology for GV assessment despite heterogeneity in the monitoring period (ranging from 48 h to 7 days). One study used the DexCom G4 Platinum technology [ 28 ] whereas seven studies used Medtronic glucose sensors [ 21 , 23 , 25 , 27 , 29 , 31 , 32 ]. One study used an intermittently scanned CGM device (using flash technology—FGM) for 14 days [ 30 ].…”

Section: Presentation Of the Resultsmentioning

confidence: 99%

“…One study used an intermittently scanned CGM device (using flash technology—FGM) for 14 days [ 30 ]. Regarding the BP assessment methodology, seven studies used ambulatory BP monitoring (ABPM) for the assessment of the participants’ BP profiles [ 20 , 24 , 25 , 27 , 28 , 31 , 32 ]. Five studies used office BP measurements [ 21 , 22 , 26 , 29 , 30 ], most of them with a significant lack of details, and a single study reported the use of self-measurements [ 23 ].…”

Section: Presentation Of the Resultsmentioning

confidence: 99%

“…There was also a high degree of heterogeneity regarding the indices reported ( Figure 1 ) and the type of associations between the GV and BP parameters examined ( Table 3 ). The most commonly studied index of GV was MAGE [ 20 , 21 , 22 , 23 , 25 , 27 , 32 ], as well as the SD of glucose [ 23 , 30 , 31 , 32 ], while for BP parameters, average levels [ 20 , 22 , 23 , 24 , 26 , 28 ], SD [ 32 ], and dipping status were studied [ 27 ]. A few studies reported positive associations between GV indices and average BP levels [ 22 , 24 , 26 ].…”

Section: Presentation Of the Resultsmentioning

confidence: 99%

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Relationship between Short- and Mid-Term Glucose Variability and Blood Pressure Profile Parameters: A Scoping Review

Vakali

Rigopoulos²,

Dinas

et al. 2023

JCM

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Background. Increased variability of glucose (GV) and blood pressure (BPV) is linked to a higher risk of macro- and microvascular complications and other hard endpoints. This scoping review aims to summarize the existing evidence regarding the association between the parameters of the blood pressure (BP) profile, especially BPV, with indices of short- and mid-term GV. Methods. A literature search was conducted in the MEDLINE/PubMed, Cochrane, Embase, Web of Science, and Wiley Online Library databases. Results. The main findings of this review are as follows: (i) 13 studies were included, mainly with small sample sizes; (ii) there was a considerable degree of heterogeneity in the characteristics of the study participants (age range, individuals with normoglycemia, type 1 or 2 diabetes, normal BP, or hypertension), as well as in the methodologies (mainly in terms of the duration of the data collection period) and variability indices examined (mean amplitude of glycemic excursions and coefficient of glucose variation most frequently reported); and (iii) the results were heterogeneous regarding the association between GV and the parameters of the BP profile. Conclusions. There is a significant lack of evidence on the association between GV and BPV. Future research implementing a standardized methodology should focus on the determinants, association, and clinical relevance of GV and BPV.

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Section: Presentation Of the Resultsmentioning

confidence: 99%

Section: Presentation Of the Resultsmentioning

confidence: 99%

Section: Presentation Of the Resultsmentioning

confidence: 99%

Section: Presentation Of the Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Relationship between Short- and Mid-Term Glucose Variability and Blood Pressure Profile Parameters: A Scoping Review

Vakali

Rigopoulos²,

Dinas

et al. 2023

JCM

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“…A large number of studies have used ABPM to measure cardiovascular function outcomes in youth with T1D and found that patients often have high blood pressure measures (eg, high systolic or diastolic pressure at different times of day), prehypertension, or higher blood pressure than their peers who do not have T1D [203,[207][208][209][210][211][212][213][214][215][216][217][218][219][220][221][222][223][224][225], with higher blood pressure-measured with ABPM being predictive of future hypertension [220]. Many factors have been found to be associated with measures of high blood pressure in this population, including higher HbA 1c [208,209,215,226], age [209], sex [208,209], diabetes duration [208,209,214,225,226], unstable glycemic control [225], insulin dose [209,215,225], BMI [209,215,226], genetics [227,228], triglycerides [214], high salt intake …”

Section: Using Abpm To Measure Outcomesmentioning

confidence: 99%

Technological Ecological Momentary Assessment Tools to Study Type 1 Diabetes in Youth: Viewpoint of Methodologies

Ray¹,

McMichael²,

Rivera-Santana³

et al. 2021

JMIR Diabetes

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Type 1 diabetes (T1D) is one of the most common chronic childhood diseases, and its prevalence is rapidly increasing. The management of glucose in T1D is challenging, as youth must consider a myriad of factors when making diabetes care decisions. This task often leads to significant hyperglycemia, hypoglycemia, and glucose variability throughout the day, which have been associated with short- and long-term medical complications. At present, most of what is known about each of these complications and the health behaviors that may lead to them have been uncovered in the clinical setting or in laboratory-based research. However, the tools often used in these settings are limited in their ability to capture the dynamic behaviors, feelings, and physiological changes associated with T1D that fluctuate from moment to moment throughout the day. A better understanding of T1D in daily life could potentially aid in the development of interventions to improve diabetes care and mitigate the negative medical consequences associated with it. Therefore, there is a need to measure repeated, real-time, and real-world features of this disease in youth. This approach is known as ecological momentary assessment (EMA), and it has considerable advantages to in-lab research. Thus, this viewpoint aims to describe EMA tools that have been used to collect data in the daily lives of youth with T1D and discuss studies that explored the nuances of T1D in daily life using these methods. This viewpoint focuses on the following EMA methods: continuous glucose monitoring, actigraphy, ambulatory blood pressure monitoring, personal digital assistants, smartphones, and phone-based systems. The viewpoint also discusses the benefits of using EMA methods to collect important data that might not otherwise be collected in the laboratory and the limitations of each tool, future directions of the field, and possible clinical implications for their use.

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Masked Hypertension in Healthy Children and Adolescents: Who Should Be Screened?

Seeman,

Šuláková,

Stabouli

2023

Curr Hypertens Rep

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Purpose of Review The goal is to review masked hypertension (MH) as a relatively new phenomenon when patients have normal office BP but elevated out-of-office BP. Firstly, it was described in children in 2004. It has received increased attention in the past decade. Recent Findings The prevalence of MH in different pediatric populations differs widely between 0 and 60% based on the population studied, definition of MH, or method of out-of-office BP measurement. The highest prevalence of MH has been demonstrated in children with chronic kidney disease (CKD), obesity, diabetes, and after heart transplantation. In healthy children but with risk factors for hypertension such as prematurity, overweight/obesity, diabetes, chronic kidney disease, or positive family history of hypertension, the prevalence of MH is 9%. In healthy children without risk factors for hypertension, the prevalence of MH is very low ranging 0–3%. Summary In healthy children, only patients with the following clinical conditions should be screened for MH: high-normal/elevated office BP, positive family history of hypertension, and those referred for suspected hypertension who have normal office BP in the secondary/tertiary center.

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Masked hypertension and its associations with glycemic variability metrics in children and adolescents with type 1 diabetes

Cited by 8 publications

References 23 publications

Relationship between Short- and Mid-Term Glucose Variability and Blood Pressure Profile Parameters: A Scoping Review

Relationship between Short- and Mid-Term Glucose Variability and Blood Pressure Profile Parameters: A Scoping Review

Technological Ecological Momentary Assessment Tools to Study Type 1 Diabetes in Youth: Viewpoint of Methodologies

Masked Hypertension in Healthy Children and Adolescents: Who Should Be Screened?

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