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Introduction: Reducing cardiovascular risk factors (CVRFs) exposure in children and youths with type 1 diabetes (T1D) is critical for cardiovascular diseases (CVD) prevention. Long-term exposure to hyperglycaemia, measured by HbA1c, had been recognized as the main factor affecting CVRFs profile. To date, the possible association between short-term glycaemic control and variability measured by continuous glucose monitoring (CGM) metrics and CVRFs has not been explored. The aim of this study was to test the hypothesis that CGM metrics independently contribute to CVRFs exposure in children and youths with T1D., Method: BMI, blood pressure (BP), lipid profile, and CGM data of 895 children and youths with T1D were analysed. Binary multivariable logistic regression analyses were performed to test independent associations between CVRFs (BMI percentile>85th, LDL-c>100 mg/dL, BP>90th percentile) and CGM metrics according to sex and adjusting for confounding factors., Results: In both sexes, metrics of hypoglycaemia and glycaemic variability (coefficient of variation [%CV]) positively correlated with BMI percentile. LDL-c positively correlated with mean glucose and metrics of hyperglycaemia. A negative correlation was found between LDL-c and time in range (TIR). No significant correlations were found between CGM metrics and BP percentiles. In both sexes, TIR<70% was significantly associated with LDL-c>100 mg/dL (OR 3.2 in males, 2.1 in females). In females, CV>36% was significantly associated with overweight (OR 2.1)., Conclusions: CGM metrics of glycaemic control and variability were significantly associated with the risk of overweight in females and high LDL-c in both sexes., (S. Karger AG, Basel.)

Objective: The primary aim of this study was to quantify the prevalence of children and adolescents with type 1 diabetes (T1D) who achieve the recommended target for coefficient of variation (CV) identifying the determining factors to reach this target. The secondary aim was to examine the relationship between CV, the other metrics derived from continuous glucose monitoring (CGM) data and clinical parameters., Method: CGM data were collected from 805 children/adolescents with T1D. Several CGM metrics and patients' characteristics were evaluated. Participants were stratified by CV ≤36% and CV >36%. Binary logistic regression analysis was run to identify the determining factors of high CV., Results: CV was positively correlated with %TBR <70 mg/dL, %TBR <54 mg/dL, %TAR >250 mg/dL, low blood glucose index, and high blood glucose index and negatively with %TIR. CV ≤36% was found in 31.4% of the subjects. The CV >36% group spent less time in %TIR, more time in hypoglycemia and hyperglycemia with lower proportion of subjects using real-time CGM and continuous subcutaneous insulin infusion. Percentage of TBR <70 mg/dL and TAR >250 mg/dL were significant predictors of CV >36%, whereas age, gender, BMI, duration of diabetes, type of CGM device, type of insulin therapy administration and %TIR were not significant predictors (p < 0.001, R2 Nagelkerke = 0.48)., Conclusions: CV identifies children and adolescents with worse glycemic control at higher risk of both hypoglycemia and hyperglycemia., (© 2021 S. Karger AG, Basel.)