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| Additional article for Therapies | |
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Continuous blood sugar measurement in order to rate hypoglycemia in type 1- diabetes
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Since Continuous blood sugar measurement is very expensive, it is mainly applied in
hospitals at the moment. As remarked in the report, patients can often only “lend out”
the instrument for some days. Still, it can provide a hint on possible ways to optimize
the blood sugar level, especially since type 1 – diabetics whose diabetes lasts rather
long, do no t realize “mild” cases of hypoglycemia. Therefore the following study has
been done.
In this study 20 patients were examined for 48 hours as outpatients - i.e. under
everyday conditions - with the instrument GlucoDay© which only differs from the
CGMS in the measuring technique. In comparison with traditional patients’ measuring
instruments the aim was – above all – to make out the past history and duration of
the hypoglycemia as well as possible cross-reactions since these are rarely known in
the “normal” life of a diabetic. In contrast to the earlier “permanent blood sugar
measurement” which often gave special emphasis on the frequency of hypoglycemia
- it was aimed at an analysis of the hypoglycemia’s course. The results were
examined for blood sugar levels below 75 mg/dl and 60 mg/dl. If the last mentioned
was noted, it was checked whether the patient had written down the corresponding
characteristics of hypoglycemia. Furthermore, the duration of the hypoglycemia and
above all the speed of the blood sugar level’s change were measured. Here, it was
once measured the average speed of drop into the hypoglycemia as well as the
average speed of rise out of it. The patients were tested a blood sugar level below
75 mg/dl 103 times and a level below 60 mg/dl 57 times. That means every tested
diabetic was hypoglycemic 5.2 times on the average in these two days. The average
blood sugar level here was about 54 mg/dl. Concerning the time of day, all
hypoglycemias were distributed evenly. The only exception were the hour between 3
and 4 pm in a negative sense and the time at night from 2 to 3 am in a positive
sense. The latter is particularly astonishing since many diabetics fear a hypoglycemia
at night. After the minimal values were reached, the blood sugar levels rose to an
average of 200 mg/dl in 161 minutes on the average. Here, the cross-reactions of the
body, like for example the output of glucagons or adrenalin, were plain to see. The
speed of drop was –1.36 mg/dl/min. on the average. Rounded up, this is
comparatively slow which means that the training programs for recognition of
hypoglycemia will possibly have to be revised and that the „cliché“ of fast
hypoglycemia seems to be disproved – at least by this study. The re-rise was almost
just as fast: 1.31 mg/dl/min.. Here, it was noticed: the lower the hypoglycemia the
stronger and faster was the bsl’s re-rise. 19 serious hypoglycemias (below 60 mg/dl)
were not recognizes by the patients themselves.
To sum up, the study provided hints for all participating diabetics on possible ways to
optimize their bsl and, in general, valuable information for scientific checkups.
Source: Strandl et al. : “Continuous Glucose-monitoring for characterization and
assessment of hypoglycemia of patients suffering from type 1 – diabetes.”
“Diabetes and Metabolism 6”, Vol. 14 (2005), p. 351-359.
Translated by Katrin Osterbart |
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