Continuous glucose monitoring system: an attractive support tool in diabetes education

Abstract

Abstract

The study was designed to determine the usefulness of the CGMS (continuous glucose monitoring system) as a support tool in type 1 diabetes education. The CGMS is a sensor system that measures interstitial glucose levels every five minutes for three or more days, by means of a microelectrode inserted in the subcutaneous tissue.

People with type 1 diabetes (n=52), who actively participated in diabetes selfmanagement programmes, were monitored with CGMS during three to five days. Patients were selected for CGMS when unsatisfied with the glycaemic results achieved, given the effort made. Ten patients used CSII, 14 used insulin glargine plus rapid acting insulin analogue and 28 used NPH insulin plus short acting insulin. All patients used blood glucose self-monitoring, with a mean of 6.5±1.4 glucose readings per day. The CGMS register was evaluated with the patient. Mean capillary glucose during the 15 days prior to CGMS, mean capillary glucose during CGMS and mean capillary glucose during the 15 days after CGMS are compared.

Discussion of the record with the patient frequently allowed detection of inappropriate solving attitudes. Mean capillary glucose dropped from 155±20mg/dL (8.60±1.11mmol/L) prior to CGMS to 143±20mg/dL (7.94±1.11mmol/L) after CGMS (p=0.000). The effectiveness of CGMS (number of patients in whom mean glucose improved) rose from 66.7% in 2001 to 70.6% in 2002, 78.9% in 2003 and 88.8% in 2004.

When the patient is involved in the analysis of glucose fluctuations, CGMS is a useful tool in diabetes education that will help achieve attitude changes because of the evidence depicted by the continuous glucose record. Experience in the use of this tool by the professional will improve its effectiveness.