Real-time continuous glucose monitoring (RT-CGM) is the latest technological breakthrough in diabetes care. Despite its limitations of lag time between sensor and blood glucose, the need for calibration, false detection of and failure to detect hypoglycemia, and mild discomfort or skin irritation reported in some users, RT-CGM is a highly beneficial tool that can be used to detect nocturnal or unrecognized hypoglycemia and glycemic variability. This, in turn, can lead to better treatment decisions, which may improve metabolic control and decrease the incidence and progression of diabetes complications. The RT-CGM devices are fairly accurate and easy to use. It is not difficult to establish a clinical RT-CGM program in the office. However, it requires persistence and an understanding of the patient's perspective of using RT-CGM so it can be presented and taught appropriately. This article discusses the benefits and limitations of RT-CGM and establishment of a RT-CGM program in the clinical setting.
Background: Premature pubarche (PP) is defined as the appearance of pubic hair before 8 years in girls and 9 years in boys, without other signs of puberty. In the USA the prevalence of childhood overweight tripled between 1980 and 2000. An association between overweight and PP has been identified. Methods: We conducted a chart review to identify patients with the diagnosis of PP who were evaluated from July 2000 to October 2005. 38 patients, 29 females and 9 males, were studied. 16 were Caucasian, 11 African-American, 10 Hispanic, and 1 Arab. Age range was 4.3–9.8 years. Auxological features were analyzed. Results: Of the 38, 20 (52.6%) had a BMI >85th percentile. Increased weight was more common among females (62%) and Hispanics (80%). The study group was taller than expected Z = 1.11 ± 0.95 (TH Z = 0.34 ± 0.86). Among the 18 children who had bone age advancement >1.5 years, 10 (56%) had a predicted height <1 SD below the TH (p = 0.005). Conclusions: In this study we confirmed the correlation between weight gain and PP. We also found that when the bone age was advanced >1.5 years, the predicted adult height was affected.
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