1. Real-Time Continuous Glucose Monitoring Significantly Reduces Severe Hypoglycemia in Hypoglycemia-Unaware Patients With Type 1 Diabetes
- Author
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Louisa Green, John C. Pickup, Stephanie A. Amiel, Pratik Choudhary, Sharmin Ramasamy, Siobhan Pender, Anna Brackenridge, and Geraldine Gallen
- Subjects
Adult ,Male ,Insulin pump ,medicine.medical_specialty ,Time Factors ,endocrine system diseases ,Injections, Subcutaneous ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Hypoglycemia ,Infusions, Subcutaneous ,Severity of Illness Index ,Insulin Infusion Systems ,Interquartile range ,Diabetes mellitus ,Internal medicine ,Severity of illness ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,Retrospective Studies ,Glycated Hemoglobin ,Advanced and Specialized Nursing ,Type 1 diabetes ,Clinical Audit ,Dose-Response Relationship, Drug ,business.industry ,nutritional and metabolic diseases ,Awareness ,Glucose clamp technique ,Prognosis ,medicine.disease ,Novel Communications in Diabetes ,Diabetes Mellitus, Type 1 ,Endocrinology ,Research Design ,Anesthesia ,Glucose Clamp Technique ,Female ,business ,Follow-Up Studies - Abstract
OBJECTIVE To evaluate the effect of continuous glucose monitoring (CGM) on the frequency of severe hypoglycemia (SH) in patients with established hypoglycemia unawareness. RESEARCH DESIGN AND METHODS We conducted a retrospective audit of 35 patients with type 1 diabetes and problematic hypoglycemia unawareness, despite optimized medical therapy (continuous subcutaneous insulin infusion/multiple daily insulin injections), who used CGM for >1 year. RESULTS Over a 1-year follow-up period, the median rates of SH were reduced from 4.0 (interquartile range [IQR] 0.75–7.25) episodes/patient-year to 0.0 (0.0–1.25) episodes/patient-year (P < 0.001), and the mean (±SD) rates were reduced from 8.1 ± 13 to 0.6 ± 1.2 episodes/year (P = 0.005). HbA1c was reduced from 8.1 ± 1.2% to 7.6 ± 1.0% over the year (P = 0.005). The mean Gold score, measured in 19 patients, did not change: 5.1 ± 1.5 vs. 5.2 ± 1.9 (P = 0.67). CONCLUSIONS In a specialist experienced insulin pump center, in carefully selected patients, CGM reduced SH while improving HbA1c but failed to restore hypoglycemia awareness.
- Published
- 2013
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