| Abstract | Cilj istraživanja: Cilj ovog istraživanja je utvrditi razinu HbA1c u odabranoj pedijatrijskoj skupini u određenom vremenskom razdoblju te usporedba da li kontrola glikemije samomjeračem ili kontrola pomoću senzora Libre utječe na regulaciju bolesti. Također je u cilju ovog istraživanja vidjeti koliko je ispitanika postiglo ciljnu razinu HbA1c ispod 7,5% odnosno prema novim smjernicama ISPAD-a razinu ispod 7,0 %.
Ispitanici i metode: U provedenom istraživanju pregledana je medicinska dokumentacija i izdvojeno je 100 ispitanika (54 muškog i 46 ženskog spola). IIT koristilo je 74 ispitanika (74%) dok je 26 ispitanika (26%) koristilo je IP.
Ispitanici su podijeljeni u dvije skupine (dobna skupina 0 g- 12 g te dobna skupina 12 g – 18 g).
Rezultati: U dobnoj skupini 0-12 godina samokontrolom glikemije samomjeračem / glukometrom prosječna razina HbA1c iznosila je 7,41% a mjerenjem pomoću senzora Libre iznosila je 7,25%. Ispitanici na IIT a kontrolu su vršili glukometrom, imali su prosjek HbA1c 7,29%; mjerenjem pomoću senzora Libre 7,25%. Ispitanici koji koriste IP imali su prosjek HbA1c mjeren samomjeračem glukometrom 7,68%, a mjeren pomoću senzora Libre 7,13%.
U dobnoj skupini 12 - 18 godina samokontrolom glikemije pomoću glukometra prosječna razina HbA1c iznosila je 7,56% a mjerenjem pomoću senzora Libre 7,43%. Ispitanici na IIT koji su kontrolu su vršili glukometrom, imali su prosjek HbA1c 7,56%; mjerenjem pomoću senzora Libre 7,54%. Ispitanici koji koriste IP imali su prosjek HbA1c samomjeračem glukometrom 7,28%, a mjeren pomoću senzora Libre 7,24%.
Sveukupni prosjek HbA1c za dobnu skupinu 0 - 12 godina iznosio je 7,3% a za dobnu skupinu 12 – 18 g iznosio je 7,52%.
Ciljnu razinu HbA1c ( < 7,5%) u dobnoj skupini 0 – 12 godina od 35 ispitanika postiglo je njih 20 (57,14%). Prosječna razina HbA1c mjerena glukometrom iznosila je 6,7%, a mjerenjem pomoću senzora Libre od 35 ispitanika postiglo je njih 22 (62,85%) te je HbA1c iznosilo je 6,77%. Ciljnu razinu HbA1c po novim smjernicama ( < 7,0%) u dobnoj skupini 0 – 12 g od 35 ispitanika postiglo je njih 13 (37,14%). Prosječna razina HbA1c mjerena glukometrom iznosila je 6,44%, a mjerenjem pomoću Libre od 35 ispitanika ciljanu razinu je postiglo (40%) te je HbA1c iznosio 6,49%.
Ciljnu razinu HbA1c ( < 7,5%) u dobnoj skupini 12 – 18 godina od 65 ispitanika postiglo je njih 32 (49,23%). Prosječna razina HbA1c mjerena glukometrom iznosila je 6,93%, a mjerenjem pomoću senzora Libre od 65 ispitanika, postiglo ga je njih 41 (63,07%) te je prosječni HbA1c iznosio 6,94%. Ciljnu razinu HbA1c po novim smjernicama ( < 7,0%) u dobnoj skupini 12 – 18 godina od 32 ispitanika postiglo je njih 15 (46,87%). Prosječna razina HbA1c mjerena glukometrom iznosila je 6,59%, a mjerenjem pomoću senzora Libre rezultat je od 41 ispitanika postignut u njih 20 (40%) i prosječni HbA1c iznosio je 6,6%.
Ciljna vrijednost HbA1c < 7,5% u dobnoj skupini 0 - 12 godina u ispitanika na IIT a koji su kontrolu vršili glukometrom iznosila je 6,62%. Od 24 ispitanika njih 14 (58,33%) postiglo je cilj. Mjerenjem pomoću senzora Libre 13 ispitanika (54,16%) od njih 24 postiglo je cilj, prosječni HbA1c iznosio je 6,72%.
Ispitanici koji koriste IP i kontrolu vrše samomjeračem glukometrom HbA1c < 7,5% postignut je u njih 4 od 11 ispitanika (36,36%) , prosječni je iznosio 6,84%. U skupini koji vrše mjerenje glikemije pomoću senzora Libre postignuto je u 9 ispitanika (81,81%).
U dobnoj skupini 0 -12 godina razinu HbA1c < 7,0 %, kod onih na IIT, postiglo je njih 11 od 24 ispitanika (45,83%). Oni koji su kontrolu vršili glukometrom imali su prosječnu razinu HbA1c 6,39%. Od 24 ispitanika koji su koristili Libre njih 11 (45,83%) je postiglo ciljnu vrijednost uz prosječni HbA1c od 6,52%.
Ispitanici koji koriste IP a kontrolu vrše glukometrom, ciljnu razinu HbA1c je postiglo samo 1 od 11 ispitanika (9,09%). Kod mjerenja pomoću Libre kod ispitanika na IP postignuto je u 4 od 11 ispitanika (36,36%).
Ciljnu razinu HbA1c < 7,5% u dobnoj skupini 12- 18 godina u ispitanika na IIT, a koji su kontrolu vršili glukometrom, od 50 ispitanika postigla je njih 28 (56%) a u skupini koji su koristili Libre njih 30 od 50 ispitanika (54,16%).
Od 15 ispitanika koji koriste IP a kontrolu vrše glukometrom ciljnu razinu HbA1c postiglo je njih 7 (46,46%) kod onih koji su koristili senzor Libre njih 9 od 11 ispitanika (81,81%).
Ciljnu razinu HbA1c < 7,0 %, u dobnoj skupini 12-18 godina, u ispitanika na IIT a koji su kontrolu vršili glukometrom postiglo je njih 9 od ukupno 50 (18%), a 11 od 50 (22%) koji su koristili senzor Libre.
U grupi onih na IP, a kontrolu vrše samomjeračem glukometrom, njih 14 od 15 (93,33%) postiglo je ciljanu razinu < 7,0% dok je kod onih koji koriste senzor Libre postignut u 4 ispitanika (26,66%).
Zaključak: U dobnoj skupini 0 – 12 godina bolju regulaciju HbA1c imali su ispitanici koji su vršili nadzor glikemije pomoću senzora Libre. Bolja regulacija kod ispitanika na IIT postignuta je mjerenjem pomoću Libre kao i kod ispitanika koji koriste IP.
U dobnoj skupini 12 – 18 godina bolju razinu HbA1c imali su ispitanici koji su vršili nadzor glikemije pomoću Libre. Prosječna vrijednost HbA1c kod ispitanika na IIT a kontrolirana samomjeračem – glukometrom bila je za mali odmak veća od preporučene kao i mjerenjem pomoću senzora Libre. Ispitanici na IP imali su zadovoljavajuće razine HbA1c.
Sveukupni prosjek ukazuje na to da je bolja razina HbA1c u dobnoj skupini 0 - 12 godina.
U ovoj dobnoj skupini, kod ispitanika na IIT kao i kod ispitanika koji koriste IP , kad analiziramo kao ciljnu nižu razinu HbA1c od < 7,0 % uočavamo da je postignuta je u višem postotku kod onih koji su koristili Libre.
Kad analiziramo kao ciljnu razinu HbA1c < 7,5% u dobnoj skupini 12 -18 godina, kod ispitanika na IIT a mjerenje su vršili samomjeračem - glukometrom, postignuta je gotovo ista regulacija kao mjerenjem pomoću senzora Libre. Također su slični rezultati postignuti i kod ispitanika na IP .
Ciljna razina HbA1c < 7,0% u dobnoj skupini 12-18 godina, a mjerenje glikemije su vršili pomoću Libre, postignuta je u gotovo sličnom postotku i kod onih na IIT i kod onih na IP. |
| Abstract (english) | Aim of the study: The aim of this study was to determine the level of HbA1c in a selected pediatric group over a set period of time, and to compare whether self-monitoring glycemic control or control using a Libre sensor provides better results in terms of disease regulation. It is also the aim of this study to see how many subjects achieved the target HbA1c level of below 7,5%, or according to thenew ISPAD guidelines a level below 7,0%.
Subjects and methods: In the conducted research, medical documentation was re-viewed and 100 subjects were selected (54 males and 46 females). IIT was used by 74 respondents (74%) while 26 respondents (26%) used IP.
Subjects were divided into two groups (age group 0 yr-12 yr and age group 12 yr-18 yr).
Results: In the age group 0-12 years, the average level of HbA1c was 7,41% when self-monitoring glycemia with a self-meter / glucometer and 7,25% when measuring with a Libre sensor. Subjects using IIT and control was performed using glucometer, had an average HbA1c of 7,29%; while when measured using a Libre sensor 7,25 %. Subjects using IP had a mean HbA1c when measured with a self-meter glucometer of 7,68% and when measured with a Libre sensor of 7,13%.
In the age group of 12-18 years, the average level of HbA1c was 7,56% when self-monitoring of glycemia using a glucometer, and 7,43% when measuring with a Libre sensor. Subjects using IIT who performed the control with a glucometer had an average HbA1c of 7,56%; while with measurement using a Libre sensor 7,54%. Subjects using IP had a mean HbA1c self-meter glucometer of 7,28%, and when measured using a Lib-re sensor 7,24%.
The overall average HbA1c for the age group 0-12 years was 7,3% and for the age group 12-18 years it was 7,52%.
The target level HbA1c (<7,5%) in the age group 0-12 years, was achieved by 20 of 35 subjects (57,14%). The average level of HbA1c measured with a glucometar was 6,7%, and when measured wih a Libre sensor, of 35 subjects, 22 (62,85%), had a HbA1c of 6,77%. With the target level of HbA1c according to the new guidelines (<7,0%) in the age group 0 – 12 years , out of 35 subjects, this was achieved by 13 (37,14%). The ave-rage level of HbA1c measuredwith a glucometer was 6,44 %, and by measuring with Libre sensor, of 35 subjects (40%) achieved a HbA1c of 6,49 %.
The target level HbA1c (<7,5%) in the age group 12-18 years , was achieved by 32 out of 65 subjects (49,23%). The average level of HbA1c meaured with a glucometer was 6,93%, and when measured using a Libre sensor, of 65 subjects, 41 (63,07%) had an average HbA1c of 6,94%. With the target level of HbA1c according to the new guideli-nes (<7,0%), in the age group 12-18 years , out of 32 respondents this was achieved by 15 ( 46,87%). The average level of HbA1c measured with a glucometer was 6,59%, and when measuring with a Libre sensor, of 41 subjects, 20 of them (40%) achieved an ave-rage HbA1c of 6,6%.
The target value of HbA1c <7,5% in the age group 0-12 years for subjects using IIT who were monitored with a glucometer, was 6,62%. Out of 24 respondents,14 achieved the target when measuring with a Libra sensor, 13 subjects out of 24 (54,16%) achieved the target, with average HbA1c of 6,72%.
Subjects using IP and performed control with a self-meter glucometer, HbA1c < 7,5% was achieved by 4 of 11 subjects (36,36%), the average was 6,84 %. In the group per-forming glycemic measurement using the Libre sensor, by was achieved in 9 subjects (81,81%).
In the age group 0 -12 years, of those using IIT, the target level of HbA1c <7,0%, was achieved by 11 of 24 subjects (45,83%). Those who controlled with a glucometer had an average HbA1c level of 6,39%. Of the 24 subjects who used Libre, 11 (45,83%) achie-ved the target value with an average HbA1c of 6,52%.
Of those subjects who use IP and control with a glucometer,the target level of HbA1c was achieved by only 1 out of 11 subjects (9,09%). When measured with sensor Libre for those subjects on IP it was achieved by 4 out of 11 subjects (36,36%).
Target level HbA1c < 7,5% in the age group 12-18 years for subjects on IIT, who con-trolled with a glucometer , was achieved by 28 out of 50 subjects (56%), and in the gro-up that used Libre, 30 of the 50 respondents (54,16%).
Of the 15 subjects who use IP and control with a glucometer, the target level of HbA1c was achieved by 7 (46,46%), while among those who used the Libre sensor, 9 out of 11 subjects (81,81%).
Target level HbA1c <7,0%, in the age group 12 -18 years for subjects on IIT, who con-trolled with a glucometer , was achieved by 9 out of 50 (18%) and 11 out of 50 (22%) for those who used Libre sensor.
In the group of those using IP, and is performed control with a self-meter glucometer, 14 out of 15 (93,33%) reached the target level <7,0%., while for those who use the Libre sensor it was achieved by 4 (26,66%).
Conclusion: In the age group 0 - 12 years, better regulation of HbA1c was achieved by subjects who measured using the Libre sensor. Better regulation for subjects on IIT was achieved by measuring with Libra as well as for subjects using IP.
In the 12-18 age group, subjects who used Libra for measuring had better HbA1c levels. The average value of HbA1c for subjects on IIT and who controlled with a self - meter - glucometer was a small deviation higher than recommended and the same occured for those who measured with the Libre sensor. Subjects on IP had satisfactory HbA1c le-vels.
The overall average indicates that HbA1c levels are better in the 0-12 age group.
In this age group, for subjects on IIT as well as subjects using IP, when analyzed at the lower target HbA1c level of < 7,0%, we notice that it was achieved in a higher percen-tage for those who used Libre.
When analyzed as a target level of HbA1c < 7,5% in the age group 12-18 years, for sub-jects on IIT where measurement was performed with a self-meter - glucometer, almost the same regulation was achieved as measured by Libra. Similar results were also achie-ved for subjests on IP.
The target level HbA1c < 7,0% in the age group 12-18 years, where glycemic measure-ments were performed using Libra, was achieved in an almost similar percentage for both those on IIT and those on IP. |
