Reproducibility and reliability of hypoglycaemic episodes recorded with Continuous Glucose Monitoring System (CGMS) in daily life

Høi-Hansen, Thomas; Pedersen‐Bjergaard, Ulrik; Thorsteinsson, Birger

doi:10.1111/j.1464-5491.2005.01552.x

Cited by 39 publications

(33 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Though we tried to select a group of type 1 diabetic patients who were relatively free of complications, it is possible that some of the older participants and those with a longer disease duration could have had occult or undiagnosed coronary artery disease. CGM systems may be less accurate than direct measurement of glucose, though the CGMS we used has been validated at low glucose levels [7]. Nevertheless, our research has confirmed that QTc lengthening and ECG abnormalities occur during naturally occurring nocturnal hypoglycaemia in patients with type 1 diabetes.…”

Section: Discussionmentioning

confidence: 66%

“…The mean absolute difference between sensor and meter glucose values was 18.4% vs 16.1%, and the Bland-Altman analysis showed a median bias of −0.1 (range −1.4 to 1.1) [6]. The system has also been shown to be accurate at hypoglycaemic levels [7]. The CGMS was calibrated in a standard way as recommended by the manufacturer, using four validated self-monitored blood glucose levels during the 24 h monitoring periods.…”

Section: Methodsmentioning

confidence: 91%

See 1 more Smart Citation

Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes—the ‘dead in bed’ syndrome revisited

et al. 2008

View full text Add to dashboard Cite

Aims/hypothesis Sudden nocturnal death in type 1 diabetes ('dead in bed' syndrome) is thought to be due to ECG QT prolongation with subsequent ventricular tachyarrhythmia in response to nocturnal hypoglycaemia. We investigated this theoretical mechanism using continuous ECG and continuous glucose monitoring in a group of patients with type 1 diabetes. Methods Twenty-five patients with type 1 diabetes (age 20-50 years) underwent two separate 24 h ECG and continuous glucose monitoring periods. Patients were fully ambulant and carried out normal daily activities. Results There were 13 episodes (26% of recordings) of nocturnal hypoglycaemia, eight of <2.2 mmol/l and five of 2.2-3.4 mmol/l. Corrected QT interval (QTc) was longer during nocturnal hypoglycaemia compared with normoglycaemic control periods (445±40 vs 415±23 ms; p=0.037). Cardiac rate and rhythm disturbances (excluding sinus tachycardia) were seen in eight of the 13 nocturnal hypoglycaemia episodes (62%). These were sinus bradycardia (<40 beats/ min; three episodes), ventricular ectopics (three episodes), atrial ectopics (one) and P wave abnormalities (one). Conclusions/interpretation This study demonstrates QTc prolongation and cardiac rate/rhythm disturbances in response to episodes of nocturnal hypoglycaemia in ambulant patients with type 1 diabetes. This may support an arrhythmic basis for the 'dead in bed' syndrome.

show abstract

Section: Discussionmentioning

confidence: 66%

Section: Methodsmentioning

confidence: 91%

Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes—the ‘dead in bed’ syndrome revisited

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Data files were generated by means of the most recent Medtronic MiniMed CGMS software, version 1.7A. Graphs were initially evaluated to identify periods with valid data, which were defined as the interval between first entered calibration value and last accepted calibration value [7]. We discarded periods containing less than four calibrations in 24 h and periods with no electrical signal.…”

Section: To the Editormentioning

confidence: 99%

“…Hypoglycaemic nights were defined by CGMS glucose readings of 2.2 mmol/l (lower detection limit of the CGMS) lasting for at least 10 min. Such episodes represent true hypoglycaemia with an 84% probability, when compared with conventional blood glucose measurements [7]. Possibly hypoglycaemic nights were defined by nadir CGMS glucose readings of 2.3-3.5 mmol/ l, and non-hypoglycaemic nights by nadir glucose readings T. Høi-Hansen (*) .…”

mentioning

confidence: 99%

The Somogyi phenomenon revisited using continuous glucose monitoring in daily life

2005

Self Cite

View full text Add to dashboard Cite

In 1959, Michael Somogyi reported that hypoglycaemia during the night was often followed by heavy glycosuria next morning [1]. Moreover, a high morning fasting blood glucose value was later attributed to nocturnal hypoglycaemia and the need to reduce the evening or bedtime dose of insulin. The Somogyi phenomenon-hypoglycaemia begetting hyperglycaemia-is believed to be due to the release of counterregulatory hormones in response to (nocturnal) insulin-induced hypoglycaemia. Despite the fact that experimental studies have rejected the existence of the Somogyi phenomenon [2][3][4], it is, in our experience, still widely believed to exist by health care professionals. Previous experimental research has been based on hospitalised patients using nocturnal blood glucose profiles or real life data with a single nocturnal blood glucose measurement. The sensitivity of the latter method for the detection of nocturnal hypoglycaemia is low [3,5], which may explain some of the reluctance to accept that the phenomenon does not exist. The recent development of continuous glucose monitoring systems has made it possible to monitor patients with type 1 diabetes in daily life.Using this technology, we tested the existence of the Somogyi phenomenon in daily life in a large cohort of type 1 diabetic subjects.All 262 patients with type 1 diabetes from a cohort included in a study of hypoglycaemia in 1999 [6] were invited to participate in a prospective observational study in 2002. The protocol was approved by the regional ethics committee. Of the patients invited, 126 (48%) gave written informed consent to participate, while four (2%) were dead, 23 (9%) had moved or did not participate for other specific reasons, 37 (14%) did not respond to the invitation, and 72 (27%) declined to participate. The participants (35% women ) had a mean (SD) age of 46 (12) years and a diabetes duration of 21 (12) years. Most (86%) of the patients were on basal bolus treatment with NPH and human insulin. The remaining patients were receiving one-or two-dose therapy, and the mean HbA 1 c was 8.5±1.0%. Patients underwent 6 days of continuous subcutaneous glucose monitoring using a continuous glucose monitoring system (CGMS) (Medtronic MiniMed; Medtronic Diabetes, Northridge, CA, USA). At day 1, the sensor was inserted into the abdominal wall. Following careful instruction about the device and protocol, initial calibration was performed and patients went home with instructions to live as normally as possible. At day 4, the sensors were replaced, and at day 7 the sensors were dismantled and data were analysed. Calibration measurements were performed four times daily with a glucose analyser (HemoCue B; HemoCue, Vedbaek, Denmark) in order to obtain optimal accuracy of the calibration curve. The glucose analysers used in the present study were calibrated identically by the manufacturer. Participants kept a diary during the entire study period, documenting insulin doses, meals and snacks, episodes of symptomatic hypoglycaemia, and the blood glucose level during t...

show abstract

“…Исследования нарушений уровня гликемии в ночной период у детей для выявления риска внезапной смерти проводятся в настоящее время преимущественно при диабете 1-го и 2-го типа [11][12][13]. В качестве предиктора ночных гипогликемий и риска вне-запной смерти у молодых взрослых при диабете и СОАС была предложена дневная сонливость [14].…”

Section: актуальные вопросы педиатрии обоснованиеunclassified

Obstructive Sleep Apnea Syndrome in Children as a Risk of Cardiovascular Pathology Development

Кожевникова

Намазова-баранова

Абашидзе

et al. 2015

ARAMS

View full text Add to dashboard Cite

Objective: Our aim was to examine the predictors of cardiovascular disorders in children affected by obstructive sleep apnea syndrome (OSAS) based on the results of polysomnography and continuous monitoring of blood glycose. Мethods: Before the examination, parents filled in questionnaires concerning their children sleep quality. The procedure was followed by the study of the sleep by means of polysomnography (Embla s 7000, USA).A system of continuous monitoring of blood glucose was applied (Guardianreal-time, Medtronicminimed, USA) by means of which a glycemic profile tissue fluid was studied. Results: A night sleep research of 120 children aged 3-16 y.o. is presented. There were 4 groups depending on the pathology: diseases of the nervous system (n =31), bronchial asthma (n =24) and overweight and obesity (n =34 (Вестник РАМН. 2015; 1: 32-40) АКТУАЛЬНЫЕ ВОПРОСЫ ПЕДИАТРИИ

show abstract

Reproducibility and reliability of hypoglycaemic episodes recorded with Continuous Glucose Monitoring System (CGMS) in daily life

Abstract: Hypoglycaemic episodes recorded by CGMS are reproducible and agreement with independent SMBG values is acceptable for retrospective recording of hypoglycaemic events with CGMS.

Cited by 39 publications

References 18 publications

Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes—the ‘dead in bed’ syndrome revisited

Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes—the ‘dead in bed’ syndrome revisited

The Somogyi phenomenon revisited using continuous glucose monitoring in daily life

Obstructive Sleep Apnea Syndrome in Children as a Risk of Cardiovascular Pathology Development

Contact Info

Product

Resources

About