The Advanced Hybrid Closed Loop Improves Glycemia Risk Index, Continuous Glucose Monitoring Index, and Time in Range in Children with Type 1 Diabetes: Real-World Data from a Single Center Study

Eviz, Elif; Mutlu, Gül Yeşiltepe; Karakus, Kagan E; Can, Ecem; Gökçe, Tuğba; Muradoğlu, Serra; Hatun, Şükrü

doi:10.1089/dia.2023.0112

Cited by 8 publications

(5 citation statements)

References 27 publications

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“…The GRI was strongly negatively correlated with the TIR, but it reflected hypoglycemia better than the TIR did 20 . Additionally, the GRI has shown greater sensitivity than the TIR in assessing glycemic improvements in patients with type 1 diabetes treated with an advanced hybrid closed loop system 12 . High glycemic variability is closely related to vascular function 21,22 and is a critical predictor of atherosclerosis in type 2 diabetes patients 23 .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…It is represented as a single numerical value on a scale of 0–100 and has the potential to provide a comprehensive assessment of overall glycemic quality 10 . Notably, it has been applied in the evaluation of the safety and effectiveness of certain treatments in pediatric patients with type 1 diabetes 11 , 12 . Furthermore, researchers also explored the association between the glycemia risk index and diabetes‐related complications.…”

Section: Introductionmentioning

confidence: 99%

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Association between glycemia risk index and arterial stiffness in type 2 diabetes

Cai,

Shen,

et al. 2024

J of Diabetes Invest

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AimThis study aims to investigate the association of glycemia risk index (GRI), a novel composite metric derived from continuous glucose monitoring (CGM), with arterial stiffness in patients with type 2 diabetes.Materials and MethodsA total of 342 adults with type 2 diabetes were enrolled between April and June 2023 from 11 communities in Shanghai, China. Medical examinations, including measurements of anthropometric parameters, blood pressure, and venous blood samples were conducted. Brachial‐ankle pulse wave velocity (baPWV) was examined to evaluate arterial stiffness. All the participants underwent a 14 day CGM recording and GRI was calculated from the CGM data.ResultsThe mean age was 70.3 ± 6.8 years, and 162 (47.4%) were male. Participants with a higher baPWV had significantly higher levels of GRI and hyperglycemia component (both P for trend < 0.05). Linear regression revealed the significant positive linear associations of the GRI with baPWV in unadjusted or adjusted models (All P < 0.05). In the multivariable logistic analysis, each increase in the GRI quartile was associated with a 1.30‐fold (95% CI 1.01–1.68, P for trend < 0.05) higher prevalence of increased arterial stiffness after adjustment for age, sex, BMI, diabetes duration, current smoking status, blood pressure, and lipid profile. Subgroup analyses showed that the association between the GRI quartiles and increased arterial stiffness was stronger among participants with a diabetes duration ≥15 years (P for interaction = 0.014).ConclusionGlycemia risk index assessed by continuous glucose monitoring is associated with increased arterial stiffness in type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between glycemia risk index and arterial stiffness in type 2 diabetes

Cai,

Shen,

et al. 2024

J of Diabetes Invest

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“…The GRI was developed in an adult population; however, patterns of glycemia, as reflected in metrics such as hemoglobin A1c (HbA1c), are known to differ in adults versus children. 5 Studies that have examined the GRI in youth with T1D showed that GRI scores differed between treatment modalities, 6-14 so the GRI metric appears to be sensitive to changes in care when assessed as an outcome; however, it is unclear how the GRI relates to other indicators of glycemia. We aimed to examine how GRI values may relate to T1D self-management habits in youth using CGMs.…”

Section: Introductionmentioning

confidence: 99%

The Glycemia Risk Index Predicts Performance of Diabetes Self-Management Habits in Youth With Type 1 Diabetes Mellitus

Panfil,

Vandervelden,

Lockee

et al. 2024

J Diabetes Sci Technol

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Background: The Glycemia Risk Index (GRI) was developed in adults with diabetes and is a validated metric of quality of glycemia. Little is known about the relationship between GRI and type 1 diabetes (T1D) self-management habits, a validated assessment of youths’ engagement in habits associated with glycemic outcomes. Method: We retrospectively examined the relationship between GRI and T1D self-management habits in youth with T1D who received care from a Midwest pediatric diabetes clinic network. The GRI was calculated using seven days of continuous glucose monitor (CGM) data, and T1D self-management habits were assessed ±seven days from the GRI score. A mixed-effects Poisson regression model was used to evaluate the total number of habits youth engaged in with GRI, glycated hemoglobin A1c (HbA1c), age, race, ethnicity, and insurance type as fixed effects and participant ID as a random effect to account for multiple clinic visits per individual. Results: The cohort included 1182 youth aged 2.5 to 18.0 years (mean = 13.8, SD = 3.5) comprising 50.8% male, 84.6% non-Hispanic White, and 64.8% commercial insurance users across a total of 6029 clinic visits. Glycemia Risk Index scores decreased as total number of habits performed increased, suggesting youth who performed more self-management habits achieved a higher quality of glycemia. Conclusions: In youth using CGMs, GRI may serve as an easily obtainable metric to help identify youth with above target glycemia, and engagement/disengagement in the T1D self-management habits may inform clinicians with suitable interventions for improving glycemic outcomes.

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“…Studies in youth with T1D have evaluated the impact of changes in diabetes care modalities (eg, initiation of hybrid closed-loop therapy) on youths’ GRI scores and HbA1c. 6-14 Prior research also demonstrates the prognostic significance of HbA1c for predicting risk for T1D-associated complications. 15 Therefore, positive correlations existing between an individual’s GRI score and longitudinal HbA1c measures may analogously suggest that the GRI holds predictive potential (similar to that of HbA1c) for identifying individuals who are at risk for suboptimal near- and long-term health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Correlation Between the Glycemia Risk Index and Longitudinal Hemoglobin A1c in Children and Young Adults With Type 1 Diabetes

Panfil,

Redel,

Vandervelden

et al. 2024

J Diabetes Sci Technol

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Background: The glycemia risk index (GRI) is a composite metric developed and used to estimate quality of glycemia in adults with diabetes who use continuous glucose monitor (CGM) devices. In a cohort of youth with type 1 diabetes (T1D), we examined the utility of the GRI for evaluating quality of glycemia between clinic visits by analyzing correlations between the GRI and longitudinal glycated hemoglobin A1c (HbA1c) measures. Method: Using electronic health records and CGM data, we conducted a retrospective cohort study to analyze the relationship between the GRI and longitudinal HbA1c measures in youth (T1D duration ≥1 year; ≥50% CGM wear time) receiving care from a Midwest pediatric diabetes clinic network (March 2016 to May 2022). Furthermore, we analyzed correlations between HbA1c and the GRI high and low components, which reflect time spent with high/very high and low/very low glucose, respectively. Results: In this cohort of 719 youth (aged = 2.5-18.0 years [median = 13.4; interquartile range [IQR] = 5.2]; 50.5% male; 83.7% non-Hispanic White; 68.0% commercial insurance), baseline GRI scores positively correlated with HbA1c measures at baseline and 3, 6, 9, and 12 months later (r = 0.68, 0.65, 0.60, 0.57, and 0.52, respectively). At all time points, strong positive correlations existed between HbA1c and time spent in hyperglycemia. Substantially weaker, negative correlations existed between HbA1c and time spent in hypoglycemia. Conclusions: In youth with T1D, the GRI may be useful for evaluating quality of glycemia between scheduled clinic visits. Additional CGM-derived metrics are needed to quantify risk for hypoglycemia in this population.

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The Advanced Hybrid Closed Loop Improves Glycemia Risk Index, Continuous Glucose Monitoring Index, and Time in Range in Children with Type 1 Diabetes: Real-World Data from a Single Center Study

Cited by 8 publications

References 27 publications

Association between glycemia risk index and arterial stiffness in type 2 diabetes

Association between glycemia risk index and arterial stiffness in type 2 diabetes

The Glycemia Risk Index Predicts Performance of Diabetes Self-Management Habits in Youth With Type 1 Diabetes Mellitus

Correlation Between the Glycemia Risk Index and Longitudinal Hemoglobin A1c in Children and Young Adults With Type 1 Diabetes

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