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Type 1 Diabetes and Glucose Monitoring

Zachary T. Bloomgarden, MD, is a practicing endocrinologist in New York, New York, and is affiliated with the Division of Endocrinology, Mount Sinai School of Medicine, New York, New York

Abbreviations: ADA, American Diabetes Association • CGM, continuous glucose monitoring • CSCII, continuous subcutaneous insulin infusion • CVD, cardiovascular disease • DCCT, Diabetes Control and Complications Trial • EDIC, Epidemiology of Diabetes Interventions and Complications • GADA, GAD antibody • IL, interleukin • IMT, intima-media thickness • LADA, latent autoimmune diabetes of adults • MAGE, mean amplitude of glycemic excursion • PPG, postprandial glucose

The first 300 words of the full text of this article appear below.

Perspectives on the News commentaries are now part of a new, free monthly CME activity. The Mount Sinai School of Medicine, New York, New York, is designating this activity for 2.0 AMA PRA Category 1 credits. If you wish to participate, review this article and visit www.diabetes.procampus.net to complete a posttest and receive a certificate. The Mount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This is the third in a series of articles based on presentations at the American Diabetes Association’s 67th Scientific Sessions, 22–26 June 2007, in Chicago, discussing aspects of type 1 diabetes and new approaches to glucose monitoring.

Aspects of type 1 diabetes

George King (Boston, MA) discussed the Joslin award for documented type 1 diabetes of at least 50 years duration. The program, which began in 1970, has awarded more than 2,100 medals so far, comprising 0.05% of individuals with type 1 diabetes in the U.S. Of the medalists, 14 have had diabetes for at least 75 years. The mean age is 71 years for males and 68 years for females, with diabetes for 58 and 57 years, respectively; mean ages of onset are 14 and 12 years, respectively. Their average A1C levels are 7% and 7.2% for men and women, and 45 and 48%, respectively, have no significant evidence of eye, kidney, or nerve disease. Of the 211 who were more closely evaluated, at mean age 67 years, age was 11 years at diagnosis, their mean BMI was 25 kg/m², and triglycerides 66, HDL 62, and LDL 84 mg/dl. Of this group, 44% have no to mild nonproliferative retinopathy, with <2 microaneurisms, 7% have moderate-to-severe nonproliferative retinopathy, and 49% have proliferative diabetic retinopathy. Complications did not correlate with C-peptide or HLA type, and A1C . . . [Full Text of this Article]

Glucose variability

CMG

Home glucose monitoring

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