Clinical Performance of Continuous Glucose Monitoring System in Type 1 Diabetics

The aim of the study was to determine whether a 3-day glucose profile is sufficiently representative of the overall metabolic control of a patient, and to evaluate clinical performance of the continuous glucose monitoring system (CGMS) in type 1 diabetic patients. Eighteen type 1 diabetics (male 7, female 11, mean age 26.7±4.6 years) were included in the study performed at Outpatient Clinic of University Department of Endocrinology, Diabetes and Metabolic Disorders in Skopje. The patient mean HbA 1c was 8.7±1.6%. All patients were treated with intensive insulin therapy (4 daily injections). CGMS (Minimed CGMS gold) was performed for 72 hours. Results were discussed with the patients and insulin treatment was adjusted. Two months later HbA 1c was determined. CGMS profiles verified blood glucose excursions unrecognized by self-monitoring measurements in all patients. A mean of 0.9±1.2 asymptomatic nocturnal hypoglycemic events per patient was recorded with CGMS during the night and early morning. Glucose period exceeding 22.2 mmol/L due to hypoglycemic event was recorded in six patients. Prolonged periods of hyperglycemia (blood glucose values >14 mmol/L for 5 hours) were recorded in eight patients. Dawn phenomenon (elevation in glucose level during the early morning) was found in four patients. The 3-day glucose profile obtained by CGMS was found to be representative of the overall metabolic control in a particular patient. CGMS is easy to perform and in our study resulted in HbA 1c improvement at 2 months.