[Metabolic/glycemic control accuracy, effect and complications of the continuous glucose monitoring system in diabetic patients].
OBJECTIVE
To evaluate the accuracy, safety and complications of the continuous glucose monitoring system (CGMS) in diabetic patients (DM). The impact of this system on metabolic/glycemic control is still under discussion.


METHODS
The 53 patients studied (47.2% male / 52.8% female), average age: 29.74+/-16.38 years, DM1 prevalence (86.8%) were submitted to 72h CGMS (Medtronic; Northridge, CA). Capillary glycemia (CG) and mean CGMS sensor's glycaemic value; correlation coefficient, glycemic excursions (CGMS vs. CG), postprandial hyperglycemia, unrecognized hypoglycemia, complications and therapeutic management after CGMS were analyzed. A1c levels were measured at baseline (1 month before) and after 3 months of the study.


RESULTS
The mean capillary glucose values were 191.3+/-45.6 vs. 192.5+/-43.9 mg/dl by CGMS sensor, with significant correlation (p=0.001). The correlation coefficient was 0.87+/-0.16 (VR>0.79). The CGMS was significantly more efficient in the detection of glycemic excursion related to capillary glycemia (p=0.001). Postprandial hyperglycemia was identified in 77.3% of diabetic patients and nocturnal unrecognized hypoglycemia was detected in 54%. Data showed a significantly decreased A1c level, three months after the CGMS (p=0.001). No complications were registered in 89.8% of patients.


CONCLUSIONS
The CGMS was confirmed to be a very safe method, with high accuracy in glycemic values and to have a low complication rate. It is a good method to identify glucose excursion, postprandial hyperglycemia and asymptomatic hypoglycemia, with a significant impact on the A1c levels of diabetic patients.
Maia
Frederico F R
FF
Departamento de Ciências Fisiológicas, Hospital Universitário São José, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais. fredfrm@hotmail.com
Araújo
Levimar R
LR
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D002196:Capillaries; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis; D007003:Hypoglycemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000009:adverse effects / Q000592:standards*; D012016:Reference Values; D012189:Retrospective Studies
D001786:Blood Glucose