Assessing glycemia in type 1 diabetic patients using a microdialysis system for continuous glucose monitoring.

Background: Continuous glucose monitoring systems can monitor moment-to-moment changes in blood glucose concentration, which cannot be detected by intermittent self-monitoring. Continuing monitoring systems may lead to improved glycemic control. We evaluated a microdialysis technique for improving glycemic control in type 1 diabetes patients treated by different means of basal insulin substitution.

Patients And Methods: Fifty-two type 1 diabetic patients on twice daily NPH and pre-meal aspart insulin were randomized in two groups: the continuation of NPH (n=26) (group 1) or once daily glargine (n=26) (group 2). 48-hour GlucoDay registrations were started at the beginning and after 4 months.

Results: At baseline, time spent in the euglycemic range (glucose between 3.9 and 8.0 mmol/L) was 37.96+/-6.81% for the NPH group and 35.83+/-6.24% for the glargine group. At endpoint, time in the euglycemic range increased in both groups (51.02+/-7.22% and 57.29+/-10.27%, P<0.001 vs. before treatment for both groups). Time spent in the hypoglycemic range (glucose <3.9 mmol/L) was 9.+/-2.57% for the first group and 10.24+/-3.55% for the second group at baseline. At endpoint, time in the hypoglycemic range decreased in both groups (8.00+/-2.13% and 6.59+/-2.04%, P<0.001 vs. before treatment for both groups).

Conclusion: The analysis of the GlucoDay data gave us information about glycemia other than HbA1c and self-monitoring of blood glucose, such us a peakless activity profile and the lower percentage of time spent in the hypoglycemic range in the glargine-treated group.