[IPu] Fw: [IP] abstract
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Subject: [IP] abstract
Pediatric Diabetes
Volume 5 Issue 3 Page 117 - September 2004
doi:10.1111/j.1399-543X.2004.00053.x
Original Article
Assessment of glycemic control by continuous glucose monitoring system in 50
children with type 1 diabetes starting on insulin pump therapy
Dorothee Deissa*, Reinhard Hartmanna, Julia Hoeffea and Olga Kordonouria
Objective: To report experience with a continuous glucose monitoring system
(CGMS) and to identify factors influencing glycemic control in a large
cohort
of children and adolescents with type 1 diabetes and change to insulin pump
therapy via continuous subcutaneous insulin infusion (CSII).
Research design and methods: In 50 patients [21 boys, 29 girls; median age
12.6 yr (range: 1.3-16.4 yr); diabetes duration 5.0 yr (0.2-13.3)],
hemoglobin
A1c (HbA1c) and ambulatory CGMS were performed before and 6 wk after
starting
CSII. Average glucose concentration per 24 h, during day and night time as
well as number of excursions, duration, and area under the curve (AUC) of
glucose
values above 180 mg/dL and below 60 mg/dL were calculated from CGMS data.
Simultaneously, metabolic control was documented by standardized
self-monitoring of blood glucose (SMBG).
Results: In the total cohort, HbA1c improved from 8.1 1 1.2% at baseline to
7.7 1 0.9% after 6 wk of CSII (p < 0.001). This effect was more distinct in
boys (8.0 1 1.4 vs. 7.5 1 1.1%, p = 0.007) than in girls (8.1 1 1.1 vs. 7.8
1
0.7%, p = 0.039) as well as in patients with poor glycemic control (HbA1c >
8.0%) at baseline (8.9 1 0.6 vs. 8.1 1 0.8%, p < 0.001) and in those older
than 12
yr (8.2 1 1.2 vs. 7.7 1 1.0%, p < 0.001). At 6 wk of CSII, the values of
glucose average per 24 h, AUC and time above 180 mg/dL, particularly during
the day, improved. HbA1c was correlated with AUC above 180 mg/dL (r = 0.742,
p <
0.001) and CGMS average glucose per 24 h (r = 0.628, p = 0.002), but to a
lesser extent with SMBG values (r = 0.418, p = 0.054).
Conclusion: With the change to CSII, HbA1c imroved significantly after 6 wk
of therapy. CGMS usage provided additional information about glycemic
control
in these patients.
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