Endocrine Abstracts

Background: Hoping to avoid repeated hypoglycaemia and yo-yo phenomena, alternative feedback was proposed based on the body “energetic balance” evolution checking. A device (ADD-CIT – Apparatus for Diagnosis of Diabetes and Complex Insulin Therapy) measuring the differences between core and superficial temperatures (Dt) evolution and programming insulin delivery was proposed and first-tested (PDT, 2015).

Objective: The present work aims at the ADD-CIT evaluation in decompensating diabetic patients.

Methods: About 148 patients with DM-1 disease – before kidney-pancreas transplantation (32), in critical situations (58) or decompensating (39) were included after informed consent. Besides current clinical analysis, blood glucose and lactate were determined once every hour during the ADD-CIT sessions. As A comparison evolution of similar patients (19) treated as usually was considered.

Results: In in 93% of the cases insulin delivery monitored by Dt evolution was efficient: blood glucose mean fall varying from 30+/−5% up to 48+/−18% (20%+/−5% in control) followed by stabilisation at an acceptable level was obtained within 3–4 hours. Mean insulin amount/hour remained between 2 and 10 UI. Hypoglycaemia (72 mg/dl) was relatively less frequent in the ADD-CIT groups, than in control. Hypoglycaemia episodes could be predicted by a Dt fall while blood glucose was still normal or even elevated. That has allowed earlier and more adequate correction. No side effect of ADD-CIT use could be noted.

Conclusion: ADD-CIT 3-4 hour sessions seem to have allowed adequate and adapted insulin monitoring in severe carbohydrate metabolism disorders. The new feedback has been an useful complement to usual glycaemia monitoring of diabetes treatment. Larger studies would be worthwhile to confirm ADD-CIY advantages and determine its limits.