Improving epinephrine responses in hypoglycemia unawareness with real-time continuous glucose monitoring in adolescents with type 1 diabetes

  1. Timothy W. Jones, FRACP MD1,5
  1. 1Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
  2. 2School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Western Australia, Australia
  3. 3PathWest Laboratory Medicine, Queen Elizabeth II, Nedlands, Western Australia, Australia
  4. 4Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  5. 5Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia

Abstract

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.

This Article

  1. Diabetes Care
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