title: Reducing glycaemic variability in type 1 diabetes self-management with a continuous glucose monitoring system based on wired enzyme technology.
abstract: OBJECTIVE
  This study was designed to investigate the use and impact of a continuous glucose monitoring system (the FreeStyle Navigator) under home-use conditions in the self-management of type 1 diabetes.
  
  
  METHODS
  A 20 day masked phase, when real-time data and alarms were not available, was compared with a subsequent 40 day unmasked phase for a number of specified measures of glycaemic variability. HbA(1c) (measured by DCA 2000) and a hypoglycaemia fear survey were recorded at the start and end of the study.
  
  
  RESULTS
  The study included 48 patients with type 1 diabetes (mean age 35.7 +/- 10.9, range 18-61 years; diabetes duration 17.0 +/- 9.5 years). Two patients did not complete the study for personal reasons. Comparing masked (all 20 days) and unmasked (last 20 days) phases, the following reductions were seen: time outside euglycaemia from 11.0 to 9.5 h/day (p = 0.002); glucose SD from 3.5 to 3.2 mmol/l (p < 0.001); hyperglycaemic time (>10.0 mmol/l) from 10.3 to 8.9 h/day (p = 0.0035); mean amplitude of glycaemic excursions (peak to nadir) down by 10% (p < 0.001); high blood glucose index down by 18% (p = 0.0014); and glycaemic risk assessment diabetes equation score down by 12% (p = 0.0013). Hypoglycaemic time (<3.9 mmol/l) decreased from 0.70 to 0.64 h/day without statistical significance (p > 0.05). Mean HbA(1c) fell from 7.6 +/- 1.1% at baseline to 7.1 +/- 1.1% (p < 0.001). In the hypoglycaemia fear survey, the patients tended to take less snacks at night-time after wearing the sensor.
  
  
  CONCLUSIONS
  Home use of a continuous glucose monitoring system has a positive effect on the self-management of diabetes. Thus, continuous glucose monitoring may be a useful tool to decrease glycaemic variability.
authors.affiliation: Kinderkrankenhaus auf der Bult, Janusz-Korczak-Allee 12, 30173 Hannover, Germany. Danne@hka.de
authors.forename: T
authors.initials: T
authors.lastname: Danne
authors.forename: H W
authors.initials: HW
authors.lastname: de Valk
authors.forename: T
authors.initials: T
authors.lastname: Kracht
authors.forename: K
authors.initials: K
authors.lastname: Walte
authors.forename: R
authors.initials: R
authors.lastname: Geldmacher
authors.forename: L
authors.initials: L
authors.lastname: Sölter
authors.forename: W
authors.initials: W
authors.lastname: von dem Berge
authors.forename: Z K
authors.initials: ZK
authors.lastname: Welsh
authors.forename: J R
authors.initials: JR
authors.lastname: Bugler
authors.forename: K
authors.initials: K
authors.lastname: Lange
authors.forename: O
authors.initials: O
authors.lastname: Kordonouri
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007003:Hypoglycemia / Q000097:blood; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods*; D018570:Risk Assessment; D012648:Self Care / Q000592:standards*; D013672:Technology / Q000639:trends; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin