Clinical Diabetes/Therapeutics

2186-PO Average Daily Risk Range in Young Children with Type 1 Diabetes: Com paring Risk Scores Generated from Continuous Glucose Sensing Versus Self-Monitoring Data L. KURT MIDYETT, LAWRENCE M. DOLAN, SCOTT W. POWERS, SUSANA R. PATTON, Kansas City, KS, Cincinnati, OH Young children with type 1 diabetes (T1DM) are susceptible to more extreme glucose variability than older patients because of their high sensitivity to insulin and variable routine (e.g., impacting activity levels and carbohydrate intake). The average daily risk range (ADRR) is a glucose variability measure developed using self-monitoring blood glucose data (SMBG) in adults with T1DM. ADRR identifi es risk for glucose excursion using the following scale: <20 low risk, 20-40 moderate risk, >40 high risk. In this study, we examined ADRR values for young children with T1DM using both continuous glucose monitoring (CGM) and SMBG data. We hypothesized that in young children 1the ADRR levels calculated from CGM (ADRRc) would refl ect greater variability than the ADRR levels calculated from SMBG (ADRRs); 2because ADRRc levels would refl ect greater variability, ADRRc would show better concurrent validity with children’s mean amplitude of glucose excursion scores (MAGE) than ADRRs levels. Forty-eight young children (5.1+1.2 years) participated. SMBG data were collected for 14 days including the period of CGM (92+37 SMBG readings). Mean duration of CGM trace was 65+19 hours (782+228 CGM readings). Children had a mean ADRRc of 55+12 and a mean ADRRs of 46+11, suggesting they are at high risk for excursion. Comparing ADRRc and ADRRs, approximately 40% of young children had a mismatch in their ADRR category and 74% of the time the ADRRc refl ected higher risk than the ADRRs. Specifi cally, 83% of young children had an ADRRc >40, compared to 69% using their ADRRs. We found a signifi cant correlation between young children’s ADRRc levels and MAGE scores (r= 0.71, p=0.01), but not between their ADRRs and MAGE scores (r=0.17, p= 0.24). In young children with T1DM, ADRR scores calculated using CGM data appear to identify greater risk for glucose excursion and to have better concurrent validity with children’s MAGE scores than ADRR scores calculated using SMBG. Thus, to study glucose variability in young children with T1DM, CGM data may provide a better assessment of risk for glycemic excursion than SMBG data.