[Is silent hypoglycemia part of ideal glycemic control in DM1 patients? - hypoglycemic state by CGMS vs. glycemic average].
BACKGROUND
To evaluate the impact of silent hypoglycemic state in glycemic control in type 1 diabetic patients (DM1) by CGMS.


METHODS
87 DM1 patients (45%M/55%F) submitted to a 72 h CGMS profile were classified in 4 groups. It was analyzed: unrecognized hypoglycemia (<70 mg/dL); duration time of silent hypoglycemia in which patients were classified into G1 (<5%), G2 (5-10%), G3 (10-20%) and G4 (>20%) of hypoglycemic state by CGMS; A1c and mean capillary glucose (MCG) in each group.


RESULTS
The silent hypoglycemia was detected in 64.5% of patients and nighttime episodes of hypoglycemia lasted longer (min) than daytime episodes in all groups (p<0.001). It was verified 41.4% of patients under than 5% of time in hypoglycemic state, 21.8% between 5-10%, 23% between 10-20% and 13.8% with more than 20% of CGMS in silent hypoglycemia. This data showed significant decreased in MCG when the duration time of silent hypoglycemia was longer (p=0.006).


CONCLUSIONS
The silent hypoglycemia is common in DM1 patients and most frequently in night time period. To take an average glycemia of 120-160 mg/dL in these patients, it was necessary a 10-20% of CGMS period in silent hypoglycemia in these patients.
Maia
Frederico Fernandes Ribeiro
FF
Departamento de Fisiologia da Faculdade de Ciências Médicas de Minas Gerais, MG, Brasil. fredfrm@hotmail.com
Araújo
Levimar R
LR
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D002196:Capillaries / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis*; D007223:Infant; D008297:Male; D012016:Reference Values; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin