Maia Frederico F R, Araújo Levimar R
Department of Internal Medicine, Hospital Universitário São José, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil.
Arq Bras Endocrinol Metabol. 2005 Aug;49(4):569-74. doi: 10.1590/s0004-27302005000400016. Epub 2005 Oct 19.
This retrospective study assessed 17 DM1 pediatric patients (15.76 +/- 4.5 years) submitted to 72 h continuous glucose monitoring system (CGMS) (Medtronic, CA). The aim of this study was to evaluate the accuracy of CGMS in children and adolescents with type 1 diabetes mellitus (DM1) and the efficacy of this method to detect unrecognized hypoglycemia in this population. It were analyzed capillary glycemia (CG) and CGMS sensors value; glycemic excursions; postprandial hyperglycemia; unrecognized hypoglycemia; complications and therapeutic management after CGMS. A1c levels were measured at the start and after 3 months of the study. Correlation coefficient during hypo, hyper, and normoglycemia and sensitivity/specificity was determined. The mean CG values were 213.8 +/- 63.4 mg/dl vs. 209.7 +/- 52.5 mg/dl by sensor, with statistical significance by Pearson's correlation (p < 0.001). There was no difference between CGMS and CG value in order to detect glycemic excursions (p = 0.32). The postprandial hyperglycemia and unrecognized hypoglycemia was detected in 66.7% and 56.2% of this patients, respectively. The correlation coefficient during hypoglycemia presented no statistical significance by Pearson's correlation (p = 0.29) vs. during hyperglycemia (p = 0.001). The CGMS sensor presented low sensitivity (63.3%) to detect hypoglycemia. This data showed important decreased level of A1c in this population 3 months after CGMS with statistical significance (p = 0.03). The CGMS showed to be a very safe method, well tolerated, with high accuracy in glycemic values and low complications rate. This results suggest that CGMS is a good method to identify postprandial hyperglycemia, to improve metabolic changes in therapeutics with significant impact in A1c of diabetic pediatric patients. This data confirmed the low sensitivity of CGMS to detect unrecognized hypoglycemia in pediatric DM1 patients.
这项回顾性研究评估了17例1型糖尿病（DM1）儿科患者（年龄15.76±4.5岁），他们接受了72小时连续血糖监测系统（CGMS）（美敦力公司，加利福尼亚州）监测。本研究的目的是评估CGMS在1型糖尿病（DM1）儿童和青少年中的准确性，以及该方法在检测该人群中未被识别的低血糖方面的有效性。分析了毛细血管血糖（CG）和CGMS传感器值；血糖波动；餐后高血糖；未被识别的低血糖；CGMS后的并发症及治疗管理。在研究开始时和3个月后测量糖化血红蛋白（A1c）水平。确定了低血糖、高血糖和正常血糖期间的相关系数以及敏感性/特异性。平均CG值为213.8±63.4mg/dl，而传感器测得的值为209.7±52.5mg/dl，经Pearson相关性分析具有统计学意义（p<0.001）。在检测血糖波动方面，CGMS和CG值之间没有差异（p=0.32）。分别在66.7%和56.2%的患者中检测到餐后高血糖和未被识别的低血糖。低血糖期间的相关系数经Pearson相关性分析无统计学意义（p=0.29），而高血糖期间有统计学意义（p=0.001）。CGMS传感器检测低血糖的敏感性较低（63.3%）。这些数据显示，在CGMS监测3个月后，该人群的A1c水平显著下降，具有统计学意义（p=0.03）。CGMS显示是一种非常安全的方法，耐受性良好，血糖值准确性高，并发症发生率低。这些结果表明，CGMS是识别餐后高血糖、改善治疗中代谢变化的良好方法，对糖尿病儿科患者的A1c有显著影响。这些数据证实了CGMS在检测儿科DM1患者未被识别的低血糖方面敏感性较低。
