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Minerva Endocrinologica 2015 Jul 10

lingua: Inglese

Continuous glucose monitoring and hypoglycemia unawareness in type 1 diabetes: a pilot study

Zalzali M. 1, Houdelet-Guerinot V. 1, Socquard E. 2, Thierry A. 3, Delemer B. 1, Lukas-Croisier C. 1

1 Department of Endocrinology, Diabetology and Nutrition, University hospital Reims;
2 .18 Street Paillot de Montabert, Troyes;
3 Methological assistance unit, University hospital Reims


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AIM: Looking for strict normoglycemia in type 1 diabetes increases the risk of hypoglycemia, exposing to hypoglycemia unawareness. It has been shown that the early correction of hypoglycemia can help recovering the perception of hypoglycemia. The purpose of this prospective study was to assess the value of sensor-augmented insulin-pump therapy to treat hypoglycemia unawareness.
METHODS: 11 patients with type 1 diabetes and partial or total hypoglycemia unawareness received sensor-augmented insulin-pump therapy combined to the low blood glucose- suspend feature (Paradigm ® Veo TM pump and Enlite ® sensors) for 3 months.
RESULTS: 80% of the patients improved their hypoglycemia unawareness with an increase in the hypoglycemia perception threshold of 31 mg/dL as evaluated by blinded continuous glucose monitoring. These results were correlated to a self-assessment quiz evaluation. Results were sustained at 6 months (3 months after patients stopped using the system). Sensitive neuropathy, untreated hypoglycemia and the area under the curve for hypoglycemia events were associated with less chance of recovery. These devices were globally considered by the patients as simple to use, with no major disadvantages and only a single withdrawal occurred.
CONCLUSION: Sensor-augmented insulin-pump therapy should be considered as a possible treatment of hypoglycemia unawareness.

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mzalzali@chu-reims.fr.