The Use of a Continuous Glucose Monitoring System in Hypoglycemic Disorders

Conrad, Susan C.; Mastrototaro, John J.; Gitelman, Stephen E.

doi:10.1515/jpem.2004.17.3.281

Cited by 31 publications

(18 citation statements)

References 3 publications

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“…Additionally, it is the first study assessing glucose homeostasis thorough CGMs in children with malaria. Continuous glucose monitoring has been advocated for many years to improve glycaemic management in critical care settings [18, 20], among diabetic patients [30, 31] or among preterm babies [32]. In the present study, the aim was to conduct a descriptive study using these CGMs to continuously assess blood glucose, and eventually detect hypoglycaemic episodes in children with malaria.…”

Section: Discussionmentioning

confidence: 99%

“…To improve monitoring of blood glucose, continuous glucose monitors (CGMs), initially developed for a more timely control of adult and paediatric patients suffering from type 1 diabetes, [16, 17], have been recently introduced in paediatric intensive care, where they are showing a high degree of agreement with standard glucometers [18–20]. …”

Section: Introductionmentioning

confidence: 99%

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Continuous determination of blood glucose in children admitted with malaria in a rural hospital in Mozambique

Madrid

Sitoe

Varo

et al. 2017

Malar J

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BackgroundHypoglycaemia is a frequent complication among admitted children, particularly in malaria-endemic areas. This study aimed to estimate the occurrence of hypoglycaemia not only upon admission but throughout the first 72 h of hospitalization in children admitted with malaria.MethodsA simple pilot study to continuously monitor glycaemia in children aged 0–10 years, admitted with malaria in a rural hospital was conducted in Southern Mozambique by inserting continuous glucose monitors (CGMs) in subcutaneous tissue of the abdominal area, producing glycaemia readings every 5 min.ResultsGlucose was continuously monitored during a mean of 48 h, in 74 children. Continuous measurements of blood glucose were available for 72/74 children (97.3%). Sixty-five of them were admitted with density-specific malaria diagnosis criteria (17 severe, 48 uncomplicated). Five children (7.7%) had hypoglycaemia (<54 mg/dL) on admission as detected by routine capillary determination. Analysing the data collected by the CGMs, hypoglycaemia episodes (<54 mg/dL) were detected in 10/65 (15.4%) of the children, of which 7 (10.8%) could be classified as severe (≤45 mg/dL). No risk factors were independently associated with the presence of at least one episode of hypoglycaemia (<54 mg/dL) during hospitalization. Only one death occurred among a normoglycaemic child. All episodes of hypoglycaemia detected by CGMs were subclinical episodes or not perceived by caregivers or clinical staff.ConclusionsHypoglycaemia beyond admission in children with malaria appears to be much more frequent than what had been previously described. The clinical relevance of these episodes of hypoglycaemia in the medium or long term remains to be determined.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Continuous determination of blood glucose in children admitted with malaria in a rural hospital in Mozambique

Madrid

Sitoe

Varo

et al. 2017

Malar J

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“…Regardless of how often fingerstick blood glucose measurements are undertaken, discrete results offer only a static picture at any point and do not provide a sense of the number, intensity, and duration of glycemic excursions (11). The recent availability of continuous glucose monitors provides the opportunity to match the demands of intensive therapy with a period of equally intensive glucose monitoring (12).…”

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confidence: 99%

Glycemic Characteristics in Continuously Monitored Patients With Type 1 and Type 2 Diabetes

et al. 2005

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OBJECTIVE -The purpose of this study was to generate normative values for periods of euglycemia as well as for daily patterns of glycemic excursions in patients with type 1 and type 2 diabetes monitored continuously for a maximum period of 21 days and blinded to glucose levels.RESEARCH DESIGN AND METHODS -This was a multicenter, prospective observational study in which 101 consecutive patients with type 1 (n ϭ 60) or type 2 (n ϭ 41) diabetes underwent blinded continuous glucose monitoring. Serial glucose measurements were divided into periods of euglycemia (70 -180 mg/dl), hyperglycemia (Ͼ180 mg/dl), and hypoglycemia (Ͻ70 mg/dl). The proportions of time patients were hypoglycemic, euglycemic, and hyperglycemic and the total areas under the curves (AUCs) were determined.RESULTS -During the observation period the 101 subjects contributed an average 287 Ϯ 132 h of continuous glucose values. Subjects remained in the euglycemic range for ϳ63% of the total day, were hypoglycemic 8%, and were hyperglycemic 29%. Hypoglycemia was more prevalent nocturnally (11 vs. 7%) and hyperglycemia diurnally (31 vs. 25%). Compared with subjects with type 2 diabetes, type 1 diabetic subjects had more frequent hypoglycemic episodes per day (2.1 vs. 1.0; P Ͻ 0.001) that were of longer duration (1.1 vs. 0.7 h; P Ͻ 0.0001), reflecting a greater number of hours per day in the hypoglycemic range (2.3 vs. 1.0 h; P Ͻ 0.0001). The mean hypoglycemic AUC values were Ͼ150% higher for type 1 compared with type 2 diabetic subjects (41 vs. 16, respectively; P Ͻ 0.0001).CONCLUSIONS -These normative data will assist in study and sample size planning for future investigations of continuous glucose monitoring and allow for qualitative comparisons with trials of therapeutic interventions aimed at reducing the occurrence of glycemic excursions.

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“…It also serves to assess the course of glycemic balance, integrating other indicators of medium-term glycemic control, like glycated hemoglobin (HbA 1c ). In some cases it plays a direct diagnostic role; it can help detect diabetic gastroparesis [10], 'hypoglycemia unawareness' [11,12], or nondiabetic BG changes, such as the hypoglycemic syndrome [13,14], glycogenesis [15], or cystic fibrosis [16]. Important information can be obtained for assessing β-cell function after pancreas transplantation (whole organ or islet cells) [17].…”

Section: 'Professional' and 'Real-time' Continuous Glucose Monitoringmentioning

confidence: 99%

Real-Time Continuous Glucose Monitoring in Adult Outpatients

Bonomo¹,

Grassi²,

Bartolo³

et al. 2014

Frontiers in Diabetes

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With real-time continuous glucose monitoring (RTCGM), the patient has a continuous picture of glucose concentrations -dynamic information with important predictive value. It is in fact a typical 'patient-oriented' tool that permits a more aggressive therapeutic approach and makes it easier to adapt therapy immediately. Currently approved RTCGM devices consist of three main components: a glucose sensor, a transmitter, and a receiver monitor. The system is defined as minimally invasive because it requires insertion into the subcutaneous cellular tissue of a fine needle to measure the glucose in the interstitial fluid directly or via an external sensor. A correct selection of patients is one of the most important factors in determining a successful application of this innovative technology. For this purpose, there are already consensus statements in a number of countries with regard to the indications of these systems. The criteria for identification of candidates are usually divided into three main categories: pediatric/adolescent, adult patients (both in the general population of type 1 diabetes and in specific settings), and pregnant women or women in the preconception period. RTCGM opens up extremely interesting prospects that are destined to radically change the concept of clinical self-management of diabetes. Considering the technical progress towards overcoming the current limitations (essentially: not optimal accuracy, invasiveness, and costs) which currently prevent its widespread use, we can expect wide diffusion of this form of monitoring in the coming years.

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The Use of a Continuous Glucose Monitoring System in Hypoglycemic Disorders

Abstract: CGMS is a useful adjunct in the diagnosis and evaluation of hypoglycemia, and for documentation of euglycemia in these patients following therapy.

Cited by 31 publications

References 3 publications

Continuous determination of blood glucose in children admitted with malaria in a rural hospital in Mozambique

Continuous determination of blood glucose in children admitted with malaria in a rural hospital in Mozambique

Glycemic Characteristics in Continuously Monitored Patients With Type 1 and Type 2 Diabetes

Real-Time Continuous Glucose Monitoring in Adult Outpatients

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