title: Continuous glucose monitoring and hypoglycemia unawareness in type 1 diabetes: a pilot study.
abstract: BACKGROUND
  Looking for strict normoglycemia in type 1 diabetes increases the risk of hypoglycemia, exposing to hypoglycemia unawareness. It has been shown that the early correction of hypoglycemia can help recovering the perception of hypoglycemia. The purpose of this prospective study was to assess the value of sensor-augmented insulin-pump therapy to treat hypoglycemia unawareness.
  
  
  METHODS
  Eleven patients with type 1 diabetes and partial or total hypoglycemia unawareness received sensor-augmented insulin-pump therapy combined to the low blood glucose-suspend feature (Paradigm® Veo™ pump and Enlite® sensors) for three months.
  
  
  RESULTS
  Eighty per cent of the patients improved their hypoglycemia unawareness with an increase in the hypoglycemia perception threshold of 31 mg/dL as evaluated by blinded continuous glucose monitoring. These results were correlated to a self-assessment quiz evaluation. Results were sustained at six months (three months after patients stopped using the system). Sensitive neuropathy, untreated hypoglycemia and the area under the curve for hypoglycemia events were associated with less chance of recovery. These devices were globally considered by the patients as simple to use, with no major disadvantages and only a single withdrawal occurred.
  
  
  CONCLUSIONS
  Sensor-augmented insulin-pump therapy should be considered as a possible treatment of hypoglycemia unawareness.
authors.affiliation: Department of Endocrinology, Diabetology and Nutrition, University Hospital Reims, Reims, France - mzalzali@chu-reims.fr.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Zalzali
authors.affiliation: Department of Endocrinology, Diabetology and Nutrition, University Hospital Reims, Reims, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Houdelet-Guerinot
authors.affiliation: Endocrinology Clinic, Troyes, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Socquard
authors.affiliation: Methological Assistance Unit, University Hospital Reims, Reims, France.
authors.forename: Aurore
authors.initials: A
authors.lastname: Thierry
authors.affiliation: Department of Endocrinology, Diabetology and Nutrition, University Hospital Reims, Reims, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Delemer
authors.affiliation: Department of Endocrinology, Diabetology and Nutrition, University Hospital Reims, Reims, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Lukas-Croisier
mesh_terms: D000328:Adult; D000368:Aged; D001364:Awareness; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis*; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies