NEW YORK (Reuters Health) – A continuous glucose monitoring system is useful in detecting abnormal patterns of glycemia in children with type 1 diabetes, which in turn can lead to improved control.
As reported in the December issue of Diabetes Care, Dr. Francine R. Kaufman and colleagues from the University of Southern California School of Medicine, Los Angeles, investigated the value of a light-weight, portable, minimally invasive system that continuously measures subcutaneous tissue interstitial glucose levels (MiniMed, Sylmar, CA), in pediatric type 1 diabetic patients.
Forty-seven patients, mean age 11.8 years and a mean diabetes duration of 5.5 years, were recruited. They were selected if they had with management problems (mean HbA1c 8.6%) or episodes of hypoglycemia.
While wearing the monitor for about 3 days, the patients were instructed to record glucose values, meals, insulin doses, exercise periods, and symptomatic hypoglycemia in a logbook. The team compared the number of high (above 150 mg/dL) and low (less than 70 mg/dL) glucose patterns discerned with the sensor or the logbook and evaluated HbA1c levels.
"In patients on injection therapy, 30 high or low glucose patterns were discerned with the logbook records and 120 patterns with the continuous glucose monitoring system," the investigators report. "These data were used to make specific recommendations that improved HbA1c values in subjects for a 3- to 6-month time period."
The researchers observed a significant change in HbA1c from 3 months before wearing the sensor to 6 months after (p = 0.04). A significant change in HbA1c was seen in post hoc analysis, from 8.6% at baseline to 8.4% at 3 months (p = 0.03).
Dr. Kaufman and colleagues conclude, "Whether a more prolonged benefit will be appreciated or repeat continuous glucose monitoring will be required needs to be investigated."
Diabetes Care 2001;24:2030-2034.
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