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[IPp] Constant glucose tracking may not improve outcomes



http://news.yahoo.com/s/nm/20060718/hl_nm/diabetes_dc_1

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
Care.
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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 by implant 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, but
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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