Comparative Study Of Glycemic Variability In Type 1 Diabetic Vs Non-Diabetic Children Using Continuous Glucose Monitoring

Background: Glycemic variability (GV) is increasingly recognized as an independent risk factor for both acute and chronic complications in diabetes, particularly in children with type 1 diabetes mellitus (T1DM). Continuous glucose monitoring (CGM) provides a detailed assessment of glucose fluctuations beyond conventional HbA1c.

Objective: To compare glycemic variability in children with T1DM and age-matched non-diabetic controls using CGM.

Methods: This hospital-based, case–control study was conducted at Yadgir Institute of Medical Sciences, Yadgir, between April and August 2025. A total of 50 children were enrolled, comprising 25 patients with T1DM on insulin therapy and 25 healthy controls. CGM was performed for 72 hours, and GV indices, including mean glucose, standard deviation (SD), coefficient of variation (CV), mean amplitude of glycemic excursions (MAGE), and time-in-range (TIR) were analyzed.

Results: Children with T1DM demonstrated significantly higher GV indices compared to controls. Mean glucose levels, SD, CV, and MAGE were elevated in the diabetic group (p < 0.05), while TIR was markedly reduced. Despite comparable age and BMI, T1DM patients experienced greater glucose fluctuations, indicating suboptimal stability in glycemic control even with insulin therapy.

Conclusion: Glycemic variability is significantly higher in children with T1DM compared to non-diabetic peers. CGM provides valuable insights into glucose dynamics that are not captured by HbA1c alone. Incorporating CGM into routine pediatric diabetes care may help optimize therapy and reduce the risk of long-term complications. Larger prospective studies are warranted to validate these findings.