Use of the GlucoWatch biographer in children with type 1 diabetes.
OBJECTIVE
To determine whether use of the GlucoWatch biographer improves glucose control in children and adolescents with type 1 diabetes.


METHODS
Forty children in poor glucose control (glycohemoglobin [HbA1c] >8%) were randomized to diabetes management with or without glucose monitoring using the biographer. Conventional glucose monitoring was performed 4 times daily in both groups. Those randomized to the biographer group were asked to wear the device 4 times per week for 3 months (intervention phase) and to perform blood glucose monitoring if the biographer alerted them that glucose was < or =70 mg/dL (3.9 mmol/L) or > or =300 mg/dL (16.7 mmol/L). After 3 months, all patients received biographers and were followed for 6 months (observation phase). HbA1c values were determined at baseline and after 1, 3, 6, and 9 months.


RESULTS
The median HbA1c was 8.6% and 8.9% (control versus biographer) at baseline and was significantly lower in the biographer group after 3 months (8.4% vs 9%). More hypoglycemia was detected when subjects were wearing the biographer, especially at night. No severe hypoglycemia occurred. During the observation phase, HbA1c values at 6 months were 8.5% and 8.3% and at 9 months were 8.6% and 8.4% in the control and biographer groups, respectively. Two children dropped out of the study, 1 because of skin irritation from using the device.


CONCLUSIONS
The GlucoWatch biographer was well tolerated by children and adolescents and significantly improved glucose control compared with standard therapy. The use of the biographer with an alarm to detect nocturnal hypoglycemia has the potential to increase the safety of diabetes management in children.
Chase
H Peter
HP
Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, Colorado, USA.
Roberts
Mary D
MD
Wightman
Clare
C
Klingensmith
Georgeanna
G
Garg
Satish K
SK
Van Wyhe
Michelle
M
Desai
Shashi
S
Harper
Wesley
W
Lopatin
Margarita
M
Bartkowiak
Miroslaw
M
Tamada
Janet
J
Eastman
Richard C
RC
D000293:Adolescent; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation* / Q000379:methods*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy / Q000652:urine; D005260:Female; D005947:Glucose / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006456:Hemoglobinuria / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D015918:Infusion Pumps, Implantable; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D011788:Quality of Life
D005947:Glucose; D006442:Glycated Hemoglobin; D007328:Insulin