Continuous Glucose Monitoring in Children and Adolescents with Congenital Adrenal Hyperplasia
Congenital adrenal hyperplasia
continuous glucose monitoring
hydrocortisone
hypoglycaemia
Journal
Journal of clinical research in pediatric endocrinology
ISSN: 1308-5735
Titre abrégé: J Clin Res Pediatr Endocrinol
Pays: Turkey
ID NLM: 101519456
Informations de publication
Date de publication:
22 11 2023
22 11 2023
Historique:
medline:
28
11
2023
pubmed:
23
5
2023
entrez:
23
5
2023
Statut:
ppublish
Résumé
Patients with congenital adrenal hyperplasia (CAH) require lifelong therapy with glucocorticoids to suppress androgen excess and substitute for deficient cortisol. An important aspect of care is the prevention of metabolic sequelae. In infants, potentially lethal nocturnal hypoglycaemia has been described. In adolescence, visceral obesity, hypertension, hyperinsulinism and insulin resistance are reported. To date, systematic studies of glucose profiles in this age group with CAH are lacking. This was a monocentric, prospective, observational study to determine the glucose profiles under different treatment regimens in a cohort of young patients with CAH. The continuous glucose monitoring device used was the latest generation FreeStyle Libre 3 The cohort consisted of 10 children/adolescents with a mean age of 11 years. Three patients exhibited morning fasting hyperglycaemia. Overall, 6 out of 10 patients had unacceptably few total values in the desired range of 70-120 mg/dL. Tissue glucose values above 140-180 mg/dL were found in 5 of 10 patients. The mean value for glycosylated haemoglobin for the cohort was of 5.8%. All pubertal adolescents with reverse circadian regimens had significantly higher glucose levels at night. Two adolescents showed asymptomatic nocturnal hypoglycaemia. Most of the patients exhibited abnormalities in glucose metabolism. Two-thirds had elevated total 24h glucose values outside the age-appropriate reference values. Thus, this aspect may need to be addressed early in life by adjusting the doses, treatment regimen or dietary measures. Consequently, reverse circadian therapy regimens should be critically indicated and closely monitored due to the potential metabolic risk.
Identifiants
pubmed: 37218136
doi: 10.4274/jcrpe.galenos.2023.2023-3-5
pmc: PMC10683536
doi:
Substances chimiques
Blood Glucose
0
Hydrocortisone
WI4X0X7BPJ
Glucose
IY9XDZ35W2
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
380-389Informations de copyright
©Copyright 2023 by Turkish Society for Pediatric Endocrinology and Diabetes / The Journal of Clinical Research in Pediatric Endocrinology published by Galenos Publishing House.
Déclaration de conflit d'intérêts
Conflict of interest: None declared
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