School-time Hyperglycemia and Prolonged Night-Time Hypoglycemia on Continuous Glucose Monitoring in Children With Type 1 Diabetes

To document glycemic patterns during school and sleep by continuous glucose monitoring system (CGMS) in school-going children with type 1 diabetes. To correlate glycemia with meal composition.

Patients with type 1 diabetes (n = 22) aged 4 to 19 years were enrolled. Food recording was taught, and a retrospective CGMS sensor was worn by them for 6 to 14 days. Dietary composition and glycemic patterns during school and sleep were analyzed.

The mean (SD) of dietary carbohydrate was 62.9 (9.2)% of daily calories (high) and protein 13 (2.5)% (low). Sensor glucose > 180 mg/dL (hyperglycemia) was detected on 73% of 139 school day CGMS records and involved 58 % of the school time. Sensor glucose < 70 mg/dL (hypoglycemia) was present on 45% of 172 nights. Time below range was 20 (25)%. Mean (SD) protein content (g) of dinner was significantly higher when it included lentil (dal) than without [20.4 (9.7) vs 15.3 (8.3); P < 0.001]. Hypoglycemia occurred less often on nights with vs without dal for dinner (42.1% vs 51.7%; P = 0.048).

Hyperglycemia during school hours was notable. The inclusion of lentil (dal) in the night meal in the traditional diet may reduce nocturnal hypoglycemia.