Another study is suggesting that continuous glucose monitoring could be a superior testing method for determining optimal control.
According to a study that appeared in the November 2001 issue of Diabetes Care, researchers at Yale University School of Medicine in New Haven, Connecticut, tested a total of 56 children with type 1 diabetes, aged 2 to 18 years, using the MiniMed Continuous Glucose Monitoring System. The children wore the MiniMed monitor for three days. Patients entered the results of four finger-stick blood samples into the monitor for calibration and kept records of food intake, exercise and hypoglycemic symptoms. Data was then downloaded, and blood-glucose patterns were identified.
The researchers say that despite satisfactory A1c levels (average 7.7%) and pre-meal glucose levels near the target range, the MiniMed monitor revealed profound after-meal high blood glucose. Almost 90 percent of the peak glucose levels after every meal were greater than 180 mg/dl, and almost 50 percent were greater than 300 mg/dl.
Additionally, the MiniMed monitor revealed frequent and prolonged low blood glucose in almost 70 percent of the children.
The researchers conclude that, despite satisfactory A1c levels and target after-meal glucose levels, children often experience night-time low blood glucose and after-meal high blood glucose levels that are not evident with routine monitoring. They suggest that repeated use of the MiniMed monitor may provide a means to optimize basal and bolus insulin replacement in people with type 1 diabetes.