Patients' evaluation of nocturnal hypoglycaemia with GlucoDay continuous glucose monitoring in paediatric patients

Acta Diabetol. 2010 Dec;47(4):295-300. doi: 10.1007/s00592-010-0181-9. Epub 2010 Mar 27.

Abstract

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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Chemical Analysis / instrumentation*
  • Blood Chemical Analysis / methods
  • Blood Glucose / analysis*
  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring / instrumentation
  • Blood Glucose Self-Monitoring / methods
  • Child
  • Circadian Rhythm* / physiology
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / therapy
  • Equipment Failure / statistics & numerical data
  • Female
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / diagnosis*
  • Hypoglycemia / epidemiology
  • Hypoglycemia / prevention & control
  • Male
  • Patient Satisfaction
  • Reproducibility of Results
  • Research Design / statistics & numerical data
  • Self Report*

Substances

  • Blood Glucose