TY  - JOUR
T1  - GLycemic patterns detected by continuous subcutaneous glucose sensing in children and adolescents with type 1 diabetes mellitus treated by multiple daily injections vs continuous subcutaneous insulin infusion
AU  - Weintrob N, Schechter A, Benzaquen H, et al
Y1  - 2004/07/01
N1  - 10.1001/archpedi.158.7.677
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 677
EP  - 684
VL  - 158
IS  - 7
N2  - Objective 
    To compare glycemic patterns by mode of therapy in children with type 1 diabetes mellitus using the Continuous Glucose Monitoring System (CGMS).Design 
    Open randomized crossover comparing 3½ months of multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII).Setting 
    Tertiary care, university-affiliated medical center.Patients 
    Twenty-three children and adolescents with type 1 diabetes mellitus.Interventions 
    The CGMS was applied for 72 hours after 1 month and at the end of each study arm.Main Outcome Measures 
    Hemoglobin A1c levels and glucose level profiles were compared between the 2 study arms and the 2 sensor applications for each arm.Results 
    The arms were similar for mean (SD) hemoglobin A1c levels (CSII, 8.0% [0.8%]; and MDI, 8.2% [0.8%]) and glucose levels. Areas under the curve were significantly larger during MDI for nocturnal and 24-hour hypoglycemia (P = .01 and .04, respectively) and for postprandial hypoglycemia and hyperglycemia (P = .03 and .05, respectively). The rate of hyperglycemia increased during CSII (P = .03), but 24-hour duration and area under the curve for hyperglycemia were similar. Compared with the first CGMS reading in each arm, the second had a longer mean duration of postprandial within-target glucose levels (P = .04), tendency for lower rate of diurnal hypoglycemic events (P = .1), shorter duration of nocturnal hypoglycemia (P = .05), and smaller 24-hour area under the curve for hypoglycemia (P = .04).Conclusions 
    Intensive treatment with CSII seemed to be associated with slightly better prebreakfast, postprandial, and within-target glucose profiles than MDI, as well as a smaller area under the curve for hypoglycemia. Lower hypoglycemia-related variables in the second sensor reading in each arm indicate that the CGMS may serve as an educational tool to decrease the rate and magnitude of hypoglycemia.
SN  - 1072-4710
M3  - doi: 10.1001/archpedi.158.7.677
UR  - http://dx.doi.org/10.1001/archpedi.158.7.677
ER  -