Continuous Glucose Monitoring in Obese/Overweight Children and Adolescents with Neurological Manifestations: A Single Reference Center Experience

Objective: Glycemic variability (GV) and its effects may play a crucial role in brain structural and functional development and maturation. It is beliewed that GV monitoring is crucial for the highlighting of the underlying mechanisms of obese/overweight pediatric patients with neurological manifestations, even if their conventional metabolic and neurological surveys are normal. Methods: The data set consisted of 8 obese/overweight pediatric patients whose initial symptoms were neurological. A medical history of patients was taken along with anthropometric measurements and neurological examinations in detailed. Glucose homeostasis were firstly evaluated by fasting blood glucose (FBG) levels, hemoglobin A1c (HbA1c) levels, insulin resistance parameters and oral glucose tolerance tests (OGTT). The participants’ GV were assessed by continuous glucose monitoring sensors (CGMs). Electroencepholography (EEG) and cranial magnetic resonance imaging (MRI) were performed to patients in indicated situations. Sleep quality questionairre was performed to all the patients. Results: The ages of patients were between 9,8-15,5 years old on admission. The female to male ratio was 7/1. The initial neurological manifestations of the patients comprised: vertiginous attacks (n:4; 50%), vertigo and presyncope/syncope (n:1; 12,5%), migrenous headaches (n:4; 50%), sleep disturbances (n:8; 100%), febril induced seizures with occipital lobe semiological features and depression (n:1; 12,5%). All the patients were in pubertal stage. GV parameters extracted from CGM signals revealed 26 times hypoglycemia, 20 times impaired fasting glucose and 3 times impaired glucose tolerance. Conclusion: CGM sensors based on the GV showed good accuracy in diagnosing the underlying pathological pathways of obese/overweight pediatric patients with neuropsychiatric manifestations.
Keywords: Continuous glucose monitoring, vertigo, migraine, sleep disturbances, seizure