The continuous glucose monitoring system is useful for detecting unrecognized hypoglycemias in patients with type 1 and type 2 diabetes but is not better than frequent capillary glucose measurements for improving metabolic control

Abstract

INTRODUCTION. To evaluate whether the continuous glucose monitoring system (CGMS; MiniMed, Sylmar, CA) is useful for investigating the incidence of unrecognized hypoglycemias in type 1 and type 2 diabetic patients and for improving metabolic control in type 1 diabetic patients.
MATERIAL AND METHODS. A total of 70 diabetic subjects (40 type 1 and 30 type 2 subjects) were monitored using the CGMS. The number of unrecognized hypoglycemias was registered. Furthermore, the 40 type 1 diabetic patients whose treatment was modified in accordance with the information obtained from the CGMS were compared with a control group of 35 different type 1 diabetic patients using intensive capillary glucose measurements. HbA1c levels were measured before the monitoring period and 3 months later.
RESULTS. The CGMS detected unrecognized hypoglycemias in 62.5% of the type 1 diabetic patients and in 46.6% of the type 2 diabetic patients. We found that 73.7% of all events occurred at night. HbA1c concentrations decreased significantly in both the group of type 1 diabetic subjects monitored with the CGMS (from 8.3 ± 1.6 to 7.5 ± 1.2%, P < 0.01) and the control group (from 8.0 ± 1.4 to 7.5 ± 0.8%, P < 0.01). The greatest reduction was observed in the subgroup of patients who started continuous subcutaneous insulin infusion therapy, both in the CGMSmonitored and control groups (from 9.4 ± 2 to 7.2 ± ± 1.4% and from 8.1 ± 1.8 to 7.1 ± 0.6%, respectively).
CONCLUSIONS. The CGMS is useful for detecting unrecognized hypoglycemias in type 1 and type 2 diabetic subjects; however, it is not better than standard capillary glucose measurements for improving metabolic control of type 1 diabetic subjects, regardless of the therapeutic regimen.