מתוך medicontext.co.il
NEW YORK (Reuters Health) – Results of a study of continuous glucose monitoring in children with type-1 diabetes highlight current limitations of conventional self-monitoring of blood glucose.
Diabetic children are often only asked to perform self-monitoring of blood glucose before meals and at bedtime. If results are in the target range, along with HbA1c measurements, "it is [usually] assumed that…overall glycemic control is adequate," researchers from Yale University in New Haven, Connecticut explain in the journal Diabetes Care for November. However, marked glycemic deviations may be missed by the "brief glimpses" provided by self-blood glucose monitoring, Dr. William V. Tamborlane and colleagues have found.
The researchers instructed 56 diabetic children between the ages of 2 and 18 years to use the MiniMed Continuous Glucose Monitoring System (CGMS) for 3 days. A glucose oxidase-based sensor is inserted into abdominal subcutaneous tissue. Four fingerstick blood samples are used to calibrate the device and, at the end of 3 days, glucose values are downloaded and analyzed.
The CGMS data showed that most of the children experienced "profound postprandial hyperglycemia" as well as "frequent and prolonged asymptomatic hypoglycemia," despite satisfactory HbA1c levels and preprandial glucose levels.
Continuous home glucose monitoring devices may be the "most important advance" in the management of diabetes in children in the past 2 decades, they believe. The "wealth of data" provided by glucose sensors will help clinicians and patients optimize basal and bolus insulin replacement, Dr. Tamborlane's team writes.
They emphasize, however, that further studies are needed on repeated use of the MiniMed CGMS device. The system is currently intended for one-time or occasional testing and not for ongoing daily use, according to an FDA statement. (See Reuters Health story, June 17, 1999.)
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