Login Register Cart 0
Generic placeholder image

Current Diabetes Reviews

Editor-in-Chief

ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Glycemic Control in Patients with Type 1 Diabetes: Comparison of Holidays versus Schooldays

Author(s): Ayman Al Hayek*, Asirvatham Alwin Robert, Khuloud Ibrahim Almonea and Mohamed Abdulaziz Al Dawish

Volume 20, Issue 9, 2024

Published on: 04 January, 2024

Article ID: e040124225257 Pages: 6

DOI: 10.2174/0115733998276061231117101716

Price: $65

conference banner
Abstract

Background and Aims: To examine the influence of school life in children and adolescents with type 1 diabetes (T1D) by comparing the glycemic control and Ambulatory Glucose Profile (AGP) between the holidays and schooldays.

Methods: This is a retrospective study conducted on 147 patients with T1D (14-19 years) who used an intermittently scanned Continuous Glucose Monitoring (isCGM) system to self-test their glucose levels during the periods of school time and holiday time. A record was maintained of the Continuous Glucose Monitoring (CGM) metrics i.e., Glucose Variability (GV) (%), mean Time in Range (TIR), Time above Range (TAR), Time below Range (TBR), and average time period of the hypoglycemic events during schooldays and the holidays.

Results: The study revealed differences between the recorded values during the holidays and schooldays, in % in target 70-180 mg/dL (38.2 vs. 49.5; p = 0.039), mean glucose (194 vs. 185; p = 0.048), frequency of low glucose events (9.2 vs. 5.1; p = 0.036), mean duration of low glucose levels (117 vs. 65; p = 0.021), % TBR below 70 mg/dL (2.9 vs. 1.45; p = 0.023), % TBR below 54 mg/dL (1.1 vs. 0.51; p = 0.031), TAR 181-250 mg/dL (21.1 vs. 16.5; p = 0.037) and TAR >250 mg/dL (8.9 vs. 6.5; p = 0.043). On comparing the HbA1c levels of the study population recorded during the holidays (8.34%) with those recorded during the schooldays (8.13%), the HbA1c values during the school days were observed to be lower; however, no significant changes were noted in the HbA1c level between the holidays and schooldays. Concerning the FreeStyle Libre (FSL) scanning, the frequency during the holidays (n = 6.2) was significantly lower than during the schooldays (n = 9.5) (p = 0.042).

Conclusion: From the findings, it appears that children with T1D have good diabetes control during schooldays rather than during the holidays. To improve their glucose control during the holidays, these patients may also benefit from receiving greater attention and guidance.

[1]
Robert AA, Al-Dawish A, Mujammami M, Dawish MAA. Type 1 Diabetes Mellitus in Saudi Arabia: A Soaring Epidemic. Int J Pediatr 2018; 2018: 1-9.
[http://dx.doi.org/10.1155/2018/9408370] [PMID: 29853923]
[2]
Los E, Wilt AS. Diabetes mellitus type 1 in children. Treasure Island (FL):: StatPearls Publishing 2021.
[3]
The International Diabetes Federation’s (IDF’s) Diabetes Atlas 10th Available from: https://diabetesatlas.org
[4]
Abdulaziz Al Dawish M, Alwin Robert A, Braham R, et al. Diabetes mellitus in Saudi Arabia: A review of the recent literature. Curr Diabetes Rev 2016; 12(4): 359-68.
[http://dx.doi.org/10.2174/1573399811666150724095130] [PMID: 26206092]
[5]
Lin X, Xu Y, Pan X, et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: An analysis from 1990 to 2025. Sci Rep 2020; 10(1): 14790.
[http://dx.doi.org/10.1038/s41598-020-71908-9] [PMID: 32901098]
[6]
Pathak V, Pathak NM, O’Neill CL, Guduric-Fuchs J, Medina RJ. Therapies for type 1 diabetes: Current scenario and future perspectives. Clin Med Insights Endocrinol Diabetes 2019; 12
[http://dx.doi.org/10.1177/1179551419844521] [PMID: 31105434]
[7]
von Scholten BJ, Kreiner FF, Gough SCL, von Herrath M. Current and future therapies for type 1 diabetes. Diabetologia 2021; 64(5): 1037-48.
[http://dx.doi.org/10.1007/s00125-021-05398-3] [PMID: 33595677]
[8]
Association AD. 1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes2020 Diabetes Care 2020; 43(1): S7-S13.
[http://dx.doi.org/10.2337/dc20-S001] [PMID: 31862744]
[9]
Amiel SA, Sherwin RS, Simonson DC, Lauritano AA, Tamborlane WV. Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes. N Engl J Med 1986; 315(4): 215-9.
[http://dx.doi.org/10.1056/NEJM198607243150402] [PMID: 3523245]
[10]
Lyons SK, Libman IM, Sperling MA. Clinical review: Diabetes in the adolescent: Transitional issues. J Clin Endocrinol Metab 2013; 98(12): 4639-45.
[http://dx.doi.org/10.1210/jc.2013-2890] [PMID: 24152689]
[11]
Foster NC, Beck RW, Miller KM, et al. State of Type 1 Diabetes management and outcomes from the T1D Exchange in 2016–2018. Diabetes Technol Ther 2019; 21(2): 66-72.
[http://dx.doi.org/10.1089/dia.2018.0384] [PMID: 30657336]
[12]
Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: Recommendations from the international consensus on time in range. Diabetes Care 2019; 42(8): 1593-603.
[http://dx.doi.org/10.2337/dci19-0028] [PMID: 31177185]
[13]
Boland EA, Grey M, Mezger JA, Tamborlane WV. A summer vacation from diabetes: Evidence from a clinical trial. Diabetes Educ 1999; 25(1): 31-40.
[http://dx.doi.org/10.1177/014572179902500105] [PMID: 10232178]
[14]
Landau Z, Lebenthal Y, Boaz M, Pinhas-Hamiel O. Observational study of diabetes management in type 1 diabetic school-age children during holiday versus school days. J Pediatr Endocrinol Metab 2013; 26(11-12): 1083-6.
[http://dx.doi.org/10.1515/jpem-2013-0045] [PMID: 23740676]
[15]
Leggett C, Giles L, Anderson JJA, Doogue M, Couper J, Pena AS. Adherence to metformin is reduced during school holidays and weekends in children with T1D participating in a randomised controlled trial. Arch Dis Child 2019; 104(4): 890-4.
[16]
Sherr JL, Boyle CT, Miller KM, Beck RW, Tamborlane WV. No summer vacation from diabetes: Glycemic control in pediatric participants in the T1D exchange registry based on time of year. Diabetes Care 2016; 39(12): e214-5.
[http://dx.doi.org/10.2337/dc16-1522] [PMID: 27703027]
[17]
Al Hayek AA, Robert AA, Al Dawish MA. Acceptability of the freestyle libre flash glucose monitoring system: the experience of young patients with type 1 diabetes. Clin Med Insights Endocrinol Diabetes 2020; 13
[http://dx.doi.org/10.1177/1179551420910122] [PMID: 32206014]
[18]
Al-Harbi MY, Albunyan A, Alnahari A, et al. Frequency of flash glucose monitoring and glucose metrics: Real-world observational data from Saudi Arabia. Diabetol Metab Syndr 2022; 14(1): 86.
[http://dx.doi.org/10.1186/s13098-022-00831-y]
[19]
Yaron M, Roitman E, Aharon-Hananel G, et al. Effect of flash glucose monitoring technology on glycemic control and treatment satisfaction in patients with type 2 diabetes. Diabetes Care 2019; 42(7): 1178-84.
[20]
March CA, Nanni M, Lutz J. Comparisons of school-day glycemia in different settings for children with T1D using continuous glucose monitoring. Pediatr Diabetes 2023; 1-11.
[21]
Gikas A, Sotiropoulos A, Pastromas V, Papazafiropoulou A, Apostolou O, Pappas S. Seasonal variation in fasting glucose and HbA1c in patients with type 2 diabetes. Prim Care Diabetes 2009; 3(2): 111-4.
[http://dx.doi.org/10.1016/j.pcd.2009.05.004] [PMID: 19535310]
[22]
Chen HS, Jap TS, Chen RL, Lin HD. A prospective study of glycemic control during holiday time in type 2 diabetic patients. Diabetes Care 2004; 27(2): 326-30.
[http://dx.doi.org/10.2337/diacare.27.2.326] [PMID: 14747208]
[23]
Ding Y, Zhang W, Wu X, et al. Deterioration in glycemic control on schooldays among children and adolescents with type 1 diabetes: A continuous glucose monitoring-based study. Front Pediatr 2022; 10: 1037261.
[http://dx.doi.org/10.3389/fped.2022.1037261] [PMID: 36568429]
[24]
Guo K, Ye J, Zhang L, et al. Effect of the chinese new year public holiday on the glycemic control of T1DM with intensive insulin therapy. Front Endocrinol 2022; 13: 915482.
[http://dx.doi.org/10.3389/fendo.2022.915482] [PMID: 35837316]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy