Type 1 diabetes; Quality of life; Insulin pump; Continuous glucose monitoring; Hypoglycaemia
Abstract :
[en] AIM: This study aimed to assess the effectiveness of continuous glucose monitoring (CGM) for glucose control in type 1 diabetic patients treated by continuous subcutaneous insulin infusion (CSII) and presenting with frequent hypoglycaemic episodes. METHODS: Thirteen patients with type 1 diabetes (diabetes duration: 25+/-15 years; CSII duration: 5.5+/-7.0 years), with more than six recorded capillary blood glucose (CBG) values <60 mg/dL, according to their metres for the past 14 days, were offered the permanent use of a CGM device (Guardian RT((R)), Medtronic) plus ongoing self-monitoring of blood glucose (SMBG) for 12 weeks, followed by a 12-week crossover period of SMBG only, or vice versa. Glucose control, determined by recorded 14-day CBG values <60 mg/dL and HbA(1c) levels, and quality of life according to the Diabetes Quality of Life (DQOL) questionnaire, were assessed at baseline, and after 12- and 24-week follow-ups. RESULTS: Four patients withdrew from the study during the first period (of whom three were using CGM). In the nine study completers, the number of low CBG values decreased significantly from 13.9+/-9.2 to 7.6+/-6.8 (P=0.011) when patients used CGM, in either the initial or final trial period, while a decrease in HbA(1c) from 8.3+/-0.7 to 7.7+/-0.6% (P=0.049) was also observed, in contrast to the absence of any significant differences during the SMBG-only period. DQOL scores were also essentially unaffected. CONCLUSION: This pilot observational study supports the hypothesis that CGM use can significantly improve overall glucose control while reducing hypoglycaemic episodes in hypoglycaemia-prone type 1 diabetic patients treated by CSII. [fr] L’apport d’une mesure continue du glucose réduit le taux d’HbA1c et la fréquence des hypoglycémies chez des patients diabétiques de type 1
traités par pompe portable à insuline et à risque hypoglycémique.
Objectif. – Étudier l’efficacité d’un système de mesure continue du glucose sur le contrôle glycémique de patients diabétiques de type 1 traités
par pompe portable à insuline et présentant des hypoglycémies fréquentes.
Méthodes. – Treize patients diabétiques de type 1 (durée du diabète : 25±15 années ; durée du traitement par pompe : 5,5±7,0 années), présentant
plus de six glycémies capillaires inférieures à 60 mg/dl enregistrées dans leur lecteur à mémoire durant les 14 derniers jours, ont participé à une étude
observationnelle. Cette dernière comprenait deux périodes de 12 semaines en ordre croisé, avec soit le recours complémentaire à un système de
monitoring du glucose (GuardianRT®, Medtronic), soit seulement la poursuite de l’autosurveillance glycémique habituelle. Le contrôle glycémique,
évalué sur la base du nombre de glycémies capillaires inférieures à 60 mg/dl au cours des 14 derniers jours et du taux d’HbA1c, et la qualité de vie
ont été analysés à l’inclusion, après 12 semaines et après 24 semaines.
Résultats. – Quatre patients se sont retirés de l’essai durant la première période (dont trois alors qu’ils étaient sous Guardian RT®). Chez les
neuf patients ayant achevé l’étude, le nombre de valeurs glycémiques basses a diminué de 13,9±9,2 à 7,6±6,8 (p = 0,011) lorsque les patients
utilisaient le Guardian RT®, que ce soit en période 1 ou en période 2, tout en obtenant une réduction du taux d’HbA1c de 8,3±0,7 à 7,7±0,6%
(p = 0,049), alors qu’il n’y avait pas de différences significatives durant la période sous simple autosurveillance glycémique habituelle. La qualité de vie n’a pas paru affectée.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Radermecker, Régis ; Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
Saint-Remy, Annie ; Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
Scheen, André ; Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale
Bringer, J.
Renard, Eric
Language :
English
Title :
Continuous glucose monitoring reduces both hypoglycaemia and HbA1c in hypoglycaemia-prone type 1 diabetic patients treated with a portable pump.
Publication date :
2010
Journal title :
Diabetes and Metabolism
ISSN :
1262-3636
eISSN :
1878-1780
Publisher :
Masson, Moulineaux Cedex 9, France
Volume :
36
Issue :
5
Pages :
409-13
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.
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