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Can continuous glucose monitoring provide objective documentation of hypoglycemia unawareness?
Streja, Dan.
Afiliação
  • Streja D; Section of Endocrinology, Veterans Affairs Medical Center of West Los Angeles, West Hills, California 91307, USA. dstreja@ucla.edu
Endocr Pract ; 11(2): 83-90, 2005.
Article em En | MEDLINE | ID: mdl-15901522
OBJECTIVE: To establish criteria defining hypoglycemia as detected by the continuous glucose monitoring system (CGMS) in patients with type 1 diabetes that best predict hypoglycemia unawareness (HUN), established by a validated questionnaire. METHODS: Adult patients were selected for inclusion in this study if they had long-standing type 1 diabetes, a fasting level of C peptide of < or = 0.6 ng/mL, commitment to achieving glycemic control, and a hemoglobin A1c value no higher than 9%. After clinical data and self-monitoring of plasma glucose data were collected, patients underwent a 72-hour glucose monitoring session with use of a Medtronic-MiniMed CGMS. The presence of HUN was determined by a questionnaire. Factors independently associated with HUN were estimated by multivariate independent analysis. RESULTS: Our study group consisted of 60 patients (33 women and 27 men) who ranged in age from 18 to 84 years (mean, 50.4) and had had diabetes for 5 to 56 years (mean, 23.8). The best predictor of HUN was the maximal duration of hypoglycemia, as determined by the CGMS (P = 0.001). Detection of hypoglycemic episodes with a duration of more than 90 minutes identified patients who had HUN with an 88% specificity and 75% sensitivity. HUN was also significantly associated with use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (P = 0.003) and with a longer duration of diabetes (P = 0.008). CONCLUSION: The CGMS can be used for objective detection of patients with HUN.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Conscientização / Glicemia / Diabetes Mellitus Tipo 1 / Hipoglicemia / Monitorização Fisiológica Tipo de estudo: Diagnostic_studies / Evaluation_studies / Prognostic_studies / Qualitative_research Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2005 Tipo de documento: Article
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Conscientização / Glicemia / Diabetes Mellitus Tipo 1 / Hipoglicemia / Monitorização Fisiológica Tipo de estudo: Diagnostic_studies / Evaluation_studies / Prognostic_studies / Qualitative_research Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2005 Tipo de documento: Article