HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Garg, S. Articles by Jovanovic, L. Search for Related Content PubMed PubMed Citation Articles by Garg, S. Articles by Jovanovic, L. Social Bookmarking                What's this?

Relationship of Fasting and Hourly Blood Glucose Levels to HbA_1c Values

Safety, accuracy, and improvements in glucose profiles obtained using a 7-day continuous glucose sensor

¹ Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Aurora, Colorado
² Sansum Diabetes Research Institute, Santa Barbara, California

Address correspondence and reprint requests to Satish Garg, MD, Professor of Medicine and Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, 1775 N. Ursula St. A140, Aurora, CO 80010. E-mail: satish.garg{at}uchsc.edu

OBJECTIVE—In this study, we evaluated the safety and efficacy of 7-day transcutaneous, real-time, continuous glucose monitoring (CGM) in subjects with insulin-requiring diabetes.

RESEARCH DESIGN AND METHODS—Eighty-six subjects were enrolled at five U.S. centers. Subjects wore a sensor inserted under the skin of the abdomen for 7 days during each of three consecutive periods. Data were blinded during period 1 and unblinded during periods 2 and 3.

RESULTS—Of the 6,811 matched self-monitoring of blood glucose to sensor values prospectively analyzed, 97.2% fell in the Clarke error grid zones A and B, and median absolute relative difference was 11.4%. After unblinding, subjects reduced time spent at <55 mg/dl by 0.3 h/day, reduced time spent at >240 mg/dl by 1.5 h/day, and increased time in the target zone (81–140 mg/dl) by 1.4 h/day (P < 0.05 for all three comparisons). Improvements were seen in both types 1 and 2 diabetes and with use of both multiple daily injections and continuous subcutaneous insulin infusion. Modal day graphs were generated in six groups of subjects based on HbA_1c (A1C) (6, 6–7, 7–8, 8–9, 9–10, and >10%). Mean glucose levels from midnight to 7:00 A.M. (fasting and dawn phenomenon periods) were only normal for subjects with A1C 6%. All other groups were hyperglycemic during this and all periods. Reductions in overall mean glucose were achieved for the four highest A1C groupings with unblinded device use.

CONCLUSIONS—This is the first report of a real-time, transcutaneous glucose sensor that functioned for 7 days. The use of CGM in the unblinded phase resulted in improvements in target-range glycemia across all A1C values.

Abbreviations: ARD, absolute relative difference • CGM, continuous glucose monitoring • CSII, continuous subcutaneous insulin infusion • MDI, multiple daily injections • SMBG, self-monitoring of blood glucose

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				L. C. Deeb Diabetes Technology During the Past 30 Years: A Lot of Changes and Mostly for the Better Diabetes Spectr, April 1, 2008; 21(2): 78 - 83. [Abstract] [Full Text] [PDF]

				M. R. Burge, S. Mitchell, A. Sawyer, and D. S. Schade Continuous Glucose Monitoring: The Future of Diabetes Management Diabetes Spectr, April 1, 2008; 21(2): 112 - 119. [Abstract] [Full Text] [PDF]

				S. K. Garg, W. C. Kelly, M. K. Voelmle, P. J. Ritchie, P. A. Gottlieb, K. K. McFann, and S. L. Ellis Continuous Home Monitoring of Glucose: Improved glycemic control with real-life use of continuous glucose sensors in adult subjects with type 1 diabetes Diabetes Care, December 1, 2007; 30(12): 3023 - 3025. [Full Text] [PDF]

				Z. T. Bloomgarden Type 1 Diabetes and Glucose Monitoring Diabetes Care, November 1, 2007; 30(11): 2965 - 2971. [Full Text] [PDF]

				G. S. Eisenbarth Update in Type 1 Diabetes J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2403 - 2407. [Abstract] [Full Text] [PDF]

				S. K. Garg On Real-Time Estimates of Blood Glucose Levels: Response to Trevino Diabetes Care, May 1, 2007; 30(5): e35 - e36. [Full Text] [PDF]