Efficacy of continuous glucose monitoring system (CGMS) to detect postprandial hyperglycemia and unrecognized hypoglycemia in type 1 diabetic patients

Abstract 

Background

To evaluate the efficacy of continuous glucose monitoring system (CGMS) to detect postprandial hyperglycemia and unrecognized hypoglycemia in type 1 diabetes mellitus (DM1) patients.

Methods

We studied 46 patients (43.4%M/56.6%F), average age of 25.9±12.8 years, submitted to 72h CGMS. It were analyzed: capillary glycemia (CG) and CGMS sensor's value, glycemic excursions, postprandial hyperglycemia, asymptomatic hypoglycemia and therapeutic management after CGMS. Correlation coefficient during hypo and hyperglycemia and sensitivity/specificity were determined.

Results

The mean capillary glucose values were 191.8±46.2mg/dl versus 190.9±42.1mg/dl by CGMS sensor, with no statistical difference by T-test (T=−0.6; p=0.79). The CGMS was significantly more efficient in detection of glycemic excursion than CG (p=0.001). The postprandial hyperglycemia was identified in 76.9% of diabetic patients and asymptomatic hypoglycemia was detected in 58.2% of these patients. The correlation coefficient presented no significance (p=0.16) during hypoglycemia versus during hyperglycemia (p=0.002). The CGMS sensor presented low sensitivity (79.1%) to detect hypoglycemia versus hyperglycemia (96.8%).

Conclusions

The CGMS showed to be a good method to identify postprandial hyperglycemia, to improve therapeutics management and confirmed the low sensitivity of CGMS to detect unrecognized hypoglycemia in DM1 patients.

Keywords: Continuous glucose monitoring system, Unrecognized hypoglycemia, Postprandial hyperglycemia, Diabetes mellitus type 1