Patients' evaluation of nocturnal hypoglycaemia with GlucoDay continuous glucose monitoring in paediatric patients.
A study was conducted to evaluate the accuracy of GlucoDay (A. Menarini Diagnostics) during 48 h of continuous glucose monitoring (CGMS) in type 1 diabetic adolescents and use this novel approach to assess otherwise ignored nocturnal hypoglycaemias, in relationship to intermediate-acting insulin administration timing. Twenty type 1 diabetic adolescents with poor metabolic control were selected from our out-patient department. Equal doses of intermediate insulin were administered at 19:00 and at 22:00 of the first and second night of the study, respectively. Correlation coefficient between GlucoDay and standard glucometer was 0.94; 98.3% of data fall in the A + B area of Error Grid Analysis and 1.7% in the D area. The mean error was 13.9% overall and 16.4% with blood glucose values (BGV) <75 mg/dl. The accuracy, ±15 mg/dl, was 82% for BGV <75 mg/dl and 74% for BGV >75 mg/dl. The CGMS discovered nocturnal hypoglycaemia (NH) in 12/18 patients, but no severe hypoglycaemia. During the first night, 8 asymptomatic NH episodes were found with BGV <60 mg/dl and 12 with BGV <80. During the second night, 4 asymptomatic NH episodes with BGV <60 mg/dl and 5 with BGV <80 were found. Furthermore, during the second night, the mean duration of BGV <126 mg/dl was lower than in the first night. GlucoDay is a reliable device for CGMS in paediatric patients and able to determine asymptomatic NH. Bedtime insulin injections provided safer glycaemic profiles and a lower percentage of hypoglycaemic events, representing a safer insulin administration scheme.
Meschi
Franco
F
Paediatric Department, Scientific Institute H San Raffaele, Vita-Salute University, Milan, Italy.
Bonfanti
Riccardo
R
Rigamonti
Andrea
A
Giulio
Frontino
F
Battaglino
Roseila
R
Viscardi
Matteo
M
Poscia
Alessandro
A
Chiumello
Giuseppe
G
D000293:Adolescent; D001774:Blood Chemical Analysis / Q000295:instrumentation* / Q000379:methods; D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000379:methods; D002648:Child; D002940:Circadian Rhythm / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000453:epidemiology / Q000628:therapy; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D012107:Research Design / Q000706:statistics & numerical data; D057566:Self Report
D001786:Blood Glucose