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[IPu] Fw: [IPp] Constant glucose tracking may not improve outcomes

From: "Rachel A" <email @ redacted>
Sent: Wednesday, July 19, 2006 1:58 AM
Subject: [IPp] Constant glucose tracking may not improve outcomes


 Constant glucose tracking may not improve outcomes

 By David Douglas Tue Jul 18, 2:49 AM ET

 NEW YORK (Reuters Health) - Continuous monitoring-guided insulin adjustment
 appears to be no more effective than intermittent fingerstick monitoring in
 achieving control of blood sugar, or blood "glucose," in certain children
 with type 1 diabetes, Australian researchers report in the Journal Diabetes

 Lead investigator Dr. Kylie Yates told Reuters Health that continuous
 glucose monitoring "can be a useful clinical tool, but in some populations
 similar improvement in control may be achieved with frequent fingersticks
 and increased review. Further work is required to identify which subgroups
 of patients will benefit most from this technology."

 Yates at The Children's Hospital, Westmead and colleagues note that one of
 the barriers to improved glycemic control in diabetes is that intermittent
 testing provides limited glucose profiles.

 To determine whether a continuous system might achieve better results, the
 researchers studied 36 children. All of the subjects had slightly elevated
 glucose levels and were on intensive diabetes treatment with continuous
 insulin infusion or insulin injections.

 The children were randomly assigned to have insulin adjustments every 3
 weeks based on the results of 72-hour of continuous glucose monitoring or
 intermittent self-monitoring with finger sticks.

 After 3 months, there was a significant improvement in glucose levels in
 both groups, but no between-group differences.

 Mild low blood sugar, or hypoglycemia, was "very common" in both groups, 
 reductions in elevated blood sugar in the continuous monitoring group was
 "at the cost of increased duration of hypoglycemia."

 The researchers conclude that although continuous monitoring might help
 certain groups of patients, it does not appear to offer any advantages in
 reasonably well-controlled outpatients.

 Specific groups to target, added Yates, may be diabetics with constantly
 elevated glucose levels or frequent episodes of hypoglycemia.

 SOURCE: Diabetes Care, July 2006.
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