Endocrine Abstracts

Continuous Glucose Monitoring (CGM) is proved to be useful for dose adjustment in patients treated with multiple insulin injection regimens or with continuous subcutaneous insulin infusion. CGM give precise information about glucose variability in type 1 diabetes but are rarely used in type 2 patients. We assessed continuous glucose monitoring systems (CGMs) as control assessment tool in patients with type 2 diabetes receiving different treatment regimens. We studied 85 patients (50 men, 35 women; mean age 43.93 ± 10.87 years, mean disease duration 21.91 ± 6.07 years) with type 2 diabetes (31 receiving non-insulin therapy, 33 treated with pre-mixed insulin, 21 on multiple insulin injections. Continuous glucose monitoring by using iProTM was performed for seven days and HbA1c was measured at the end of this period. High positive correlation was found between HbA1c (7.46 ± 1.19%) and average glucose level during CGM period (7.45 ± 1.57 mmol/l) (r = 0.73), AUC above limit (r = 0.75) and percentage of time spent with glucose above 7.8 mmol/l (38.26 ± 26.38%, P < 0.05, r = 0.69). There was similar but negative correlation between HbA1c and percentage of time within the limit 3.9–7.8 mmol/l for all groups (56.07 ± 24.28%, P < 0.05, r = –0.63). Comparing CGM results in different treatment groups we found similar correlations of HbA1c and percentage of time spent within limit (non-insulin treated group 55.65 ± 25.99%, phi₁ = –0.48; premixed insulin treated group 54.33 ± 24.85%, phi₂ = –0.67; intensified insulin treatment group 59.62 ± 21.36%, phi₂ = –0.58). No correlations were found between HbA1c and number of all, positive and negative excursions. These results do not differ for age and gender. We conclude that performing CGM in patients with type 2 diabetes could give more precise information about the overall control nevertheless short time reflected and could present details about glucose deviations and hypoglycemic episodes and thus be useful for current treatment adjustment.