Maia Frederico F R, Araújo Levimar R
Department of Physiology, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. fredfrmhotmail.com
Diabetes Res Clin Pract. 2007 Jan;75(1):30-4. doi: 10.1016/j.diabres.2006.05.009. Epub 2006 Jun 27.
To evaluate the efficacy of continuous glucose monitoring system (CGMS) to detect postprandial hyperglycemia and unrecognized hypoglycemia in type 1 diabetes mellitus (DM1) patients.
We studied 46 patients (43.4%M/56.6%F), average age of 25.9+/-12.8 years, submitted to 72 h 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.
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%).
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.
评估连续血糖监测系统（CGMS）检测1型糖尿病（DM1）患者餐后高血糖和未被识别的低血糖的疗效。
我们研究了46例患者（男性占43.4%/女性占56.6%），平均年龄25.9±12.8岁，接受了72小时的CGMS监测。分析了：毛细血管血糖（CG）和CGMS传感器的值、血糖波动、餐后高血糖、无症状低血糖以及CGMS监测后的治疗管理。确定了低血糖和高血糖期间的相关系数以及敏感性/特异性。
毛细血管平均血糖值为191.8±46.2mg/dl，而CGMS传感器测得的值为190.9±42.1mg/dl，经t检验无统计学差异（t=-0.6；p=0.79）。CGMS在检测血糖波动方面比CG显著更有效（p=0.001）。76.9%的糖尿病患者被识别出餐后高血糖，58.2%的患者检测到无症状低血糖。低血糖期间与高血糖期间的相关系数无显著性差异（p=0.16），而高血糖期间有显著性差异（p=0.002）。CGMS传感器检测低血糖的敏感性较低（79.1%），而检测高血糖的敏感性较高（96.8%）。
CGMS是识别餐后高血糖、改善治疗管理的好方法，并证实了CGMS在检测DM1患者未被识别的低血糖方面敏感性较低。
