Nocturnal hypoglycaemias in type 1 diabetic patients: what can we learn with continuous glucose monitoring?

Détails

ID Serval
serval:BIB_743CF1EE1A94
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Nocturnal hypoglycaemias in type 1 diabetic patients: what can we learn with continuous glucose monitoring?
Périodique
Diabetes & metabolism
Auteur(s)
Guillod L., Comte-Perret S., Monbaron D., Gaillard R.C., Ruiz J.
ISSN
1262-3636
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
33
Numéro
5
Pages
360-5
Langue
anglais
Notes
Publication types: Journal Article - Publication Status: ppublish
Résumé
AIM: In type 1 diabetic patients (T1DM), nocturnal hypoglycaemias (NH) are a serious complication of T1DM treatment; self-monitoring of blood glucose (SMBG) is recommended to detect them. However, the majority of NH remains undetected on an occasional SMBG done during the night. An alternative strategy is the Continuous glucose monitoring (CGMS), which retrospectively shows the glycaemic profile. The aims of this retrospective study were to evaluate the true incidence of NH in T1DM, the best SMBG time to predict NH, the relationship between morning hyperglycaemia and NH (Somogyi phenomenon) and the utility of CGMS to reduce NH. METHODS: Eighty-eight T1DM who underwent a CGMS exam were included. Indications for CGMS evaluation, hypoglycaemias and correlation with morning hyperglycaemias were recorded. The efficiency of CGMS to reduce the suspected NH was evaluated after 6-9 months. RESULTS: The prevalence of NH was 67% (32% of them unsuspected). A measured hypoglycaemia at bedtime (22-24 h) had a sensitivity of 37% to detect NH (OR=2.37, P=0.001), while a single measure < or =4 mmol/l at 3-hour had a sensitivity of 43% (OR=4.60, P<0.001). NH were not associated with morning hyperglycaemias but with morning hypoglycaemias (OR=3.95, P<0.001). After 6-9 months, suspicions of NH decreased from 60 to 14% (P<0.001). CONCLUSION: NH were highly prevalent and often undetected. SMBG at bedtime, which detected hypoglycaemia had sensitivity almost equal to that of 3-hour and should be preferred because it is easier to perform. Somogyi phenomenon was not observed. CGMS is useful to reduce the risk of NH in 75% of patients.
Mots-clé
Adult, Blood Glucose, Body Mass Index, Circadian Rhythm, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemia, Male, Middle Aged, Monitoring, Ambulatory, Retrospective Studies
Pubmed
Web of science
Open Access
Oui
Création de la notice
15/02/2008 17:57
Dernière modification de la notice
08/05/2019 20:27
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