[Continuous glucose monitoring: a critical appraisal after one year experience].
Conventional assessment of glycemic control in diabetes mellitus (DM) includes blood glucose attention to glycemia and glycated hemoglobin levels. Recently, we introduced the continuous glucose-monitoring test (CGM) (Medtronic Minimed-CGMS System Gold). Here we describe our experience with this methodology over the year 2004. A total of 141 CGM tests were performed over this period of time. Overall, 88% (n= 124) patients were diabetics (DM), 99 of them were insulin users. We found a strong correlation between glucose values obtained by CGM and capillary glucose measures (r= 0.926; p< 0.005). In diabetic patients, nocturnal hypoglycemia (< 50 mg/dL) was identified in approximately 35% (n= 44), hyperglycemic patterns (> 220 mg/dL) at specific times of day in approximately 44% and sustained hyperglycemia throughout the whole monitoring period in thirteen cases (10%). Twelve tests were performed to investigate the occurrence of hypoglycemia in non-diabetic subjects. Two tests came out very suggestive of "dumping", and in one case the CGMS supported the hypothesis of insulinoma. Partial monitoring interruptions have occurred in 15% of all tests. We concluded that CGMS is a useful methodology to investigate glycemic fluctuations, and it is also an important tool to adjust therapy in diabetic patients.
Centro de Provas Funcionais e Núcleo Integrado de Diabetes, Fleury-Medicina Diagnóstica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP.
Cláudia H M C de
CH
Oliveira
Karina
K
Berger
Sílvia Coral de A L E
SC
Souza
Suemi
S
Marui
Cristina
C
Khawali
Omar M
OM
Hauache
José Gilberto H
JG
Vieira
Rui M B
RM
Maciel
André F
AF
Reis
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring / Q000009:adverse effects / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000097:blood*; D004377:Dumping Syndrome / Q000175:diagnosis; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007003:Hypoglycemia / Q000517:prevention & control; D007223:Infant; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000009:adverse effects / Q000592:standards*; D018709:Statistics, Nonparametric; D013997:Time Factors