[Continuous glucose monitoring with type 1 diabetes mellitus].
BACKGROUND
Appropriate metabolic control of children with type 1 diabetes mellitus (DM) is based on frequent measurements of capillary glycemia. However, this method offers only partial information on fluctuations in glycemia during the day, while episodes of postprandial hyperglycemia and hypoglycemia, mainly nocturnal, go unnoticed.


OBJECTIVE
To analyze pre- and postprandial blood glucose levels, as well as the presence and duration of hypoglycemic episodes in diabetic children aged more than 8 years old with more than one year of disease duration.


METHODS
Seventeen patients of both sexes (mean age: 12 years old) with type 1 DM were monitored with the continuous glucose monitoring system (CGMS) during working days. Maximum values of pre- and postprandial glucose (1-3 hours after breakfast, lunch and dinner) were registered. Data were downloaded with a Com-station.


RESULTS
The mean duration of sensor-wearing was 2.97 days. Pre- and postprandial values were high: mean preprandial values were between 144.9 and 160.5 mg % and mean postprandial values were between 230.4 and 248.8 mg %. The mean number of hypoglycemic episodes detected with the sensor was 4.9 compared with 1.8 detected with the glucometer (p < 0.05). Episodes of mainly nocturnal asymptomatic hypoglycemia were detected with a mean duration of 145 minutes during the night and 75 minutes during the day.


CONCLUSIONS
The use of continuous subcutaneous glucose monitoring demonstrates that glycemic objectives are not achieved by conventional insulin therapy. It also shows that there are a high number of hypoglycemic episodes, most of which are asymptomatic.
López-Siguero
J P
JP
Sección de Endocrinología Pediátrica. Hospital Materno-Infantil. Complejo Hospitalario Carlos Haya. Málaga. España.
García Arias
M J
MJ
del Pino de la Fuente
A
A
Moreno Molina
J A
JA
D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000295:instrumentation
D001786:Blood Glucose