Improving epinephrine responses in hypoglycemia unawareness with real-time continuous glucose monitoring in adolescents with type 1 diabetes
- Trang T. Ly, FRACP ()1,
- Jacqueline Hewitt, FRACP1,
- Raymond J. Davey, BSc (Hons)2,
- Ee Mun Lim, FRCPA FRACP3,4,
- Elizabeth A. Davis, FRACP1,5 and
- Timothy W. Jones, FRACP MD1,5
- 1Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- 2School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Western Australia, Australia
- 3PathWest Laboratory Medicine, Queen Elizabeth II, Nedlands, Western Australia, Australia
- 4Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- 5Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
Objective. To determine whether real-time continuous glucose monitoring (CGM), with preset alarms at specific glucose levels would prove a useful tool to achieve avoidance of hypoglycemia and improve the counterregulatory response to hypoglycemia in adolescents with type 1 diabetes with hypoglycemia unawareness.
Research design and methods. Adolescents with type 1 diabetes with hypoglycemia unawareness underwent hyperinsulinemic hypoglycemic clamp studies at baseline to determine their counterregulatory hormone responses to hypoglycemia. Subjects were then randomised to either standard therapy or real-time CGM for 4 weeks. The clamp study was then repeated.
Results. The epinephrine response during hypoglycemia after the intervention was greater in the CGM group compared to standard therapy.
Conclusions. A greater epinephrine response during hypoglycemia suggests that real-time CGM is a useful clinical tool to improve hypoglycemia unawareness in adolescents with type 1 diabetes.
- Received June 3, 2010.
- Accepted September 30, 2010.
- Copyright © American Diabetes Association