Type 1 Diabetes In Adults Better Controlled With Continuous Monitors

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Main Category: Diabetes
Also Included In: Medical Devices / Diagnostics
Article Date: 09 Sep 2008 - 0:00 PST

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A study by a diabetes research foundation discovered that adults with type 1 diabetes were better at controlling their glucose levels when instead of the traditional method of pricking a finger a few times a day, they used continuous monitors that sampled blood every five minutes through a small tube under the skin and alerted them so they could adjust their eating or take insulin more promptly.

The study was carried out by the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group and is being presented this week at the 44th European Association for the Study of Diabetes annual meeting in Rome. The results are also published in the 8th September online issue of the New England Journal of Medicine, NEJM.

The researchers tested 3 devices made by Abbott Laboratories, Medtronic and DexCom Inc. The results showed that adults with type 1 diabetes who used the devices consistently kept their blood glucose levels within the desired limits.

The research was done because nobody had yet evaluated the benefit of continuous monitoring in the management of type 1 diabetes mellitus.

Type 1 diabetes is an autoimmune disease that destroys insulin producing cells in the pancreas. Control of blood sugar in diabetes reduces the risk of blindness (diabetic retinopathy), kidney failure, heart disease and amputation.

For the study, the researchers randomly assigned 322 adults and children participating in a multicenter clinical trial and who were already being treated for type 1 diabetes to two groups. One group was fitted with continuous monitoring devices and the other group, the control group, continued to manage their blood glucose with a home monitor as normal (the traditional "finger pricking" method).

The main measurement point was the change in blood glucose after 26 weeks. When they started, all patients had blood glucose (a1c or glycated hemoglobin) levels ranging from 7 to 10 per cent.

The results showed that: The researchers concluded that:

"Continuous glucose monitoring can be associated with improved glycemic control in adults with type 1 diabetes."

As far as younger patients were concerned, they concluded that:

"Further work is needed to identify barriers to effectiveness of continuous monitoring in children and adolescents."

Dr Aaron Kowalski of the Juvenile Diabetes Research Foundation, which funded and carried out the study, told reporters in a telephone interview reported by Reuters:

"These results are very important because they show that continuous glucose monitors are more than simply devices of convenience for people with diabetes -- they are tools that can substantially improve blood sugar control when used regularly."

"Every 10 percent you lower your a1c [glycated hemoglobin] is about a 40 percent reduction in the risk of diabetic retinopathy," said Kowalski.

According to the Juvenile Diabetes Research Foundation there are about 3 million Americans living with type 1 diabetes.

"Continuous Glucose Monitoring and Intensive Treatment of Type 1 Diabetes."
The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group.
NEJM, Published online September 8, 2008.
DOI: 10.1056/NEJMoa0805017.

Click here for Abstract.

Source: NEJM, Reuters.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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