Constant glucose tracking may not improve outcomes

NEW YORK, July 18 (Reuters) Continuous monitoring-guided insulin adjustment appears to be no more effective than intermittent fingerstick monitoring in achieving control of blood sugar, or blood ''glucose,'' in certain children with type 1 diabetes, Australian researchers report in the journal Diabetes Care.

Lead investigator Dr Kylie Yates told Reuters Health that continuous glucose monitoring ''can be a useful clinical tool, but in some populations similar improvement in control may be achieved with frequent fingersticks and increased review.

Further work is required to identify which subgroups of patients will benefit most from this technology.'' Yates at The Children's Hospital, Westmead and colleagues note that one of the barriers to improved glycemic control in diabetes is that intermittent testing provides limited glucose profiles.

To determine whether a continuous system might achieve better results, the researchers studied 36 children. All of the subjects had slightly elevated glucose levels and were on intensive diabetes treatment with continuous insulin infusion by implant or insulin injections.

The children were randomly assigned to have insulin adjustments every 3 weeks based on the results of 72-hour of continuous glucose monitoring or intermittent self-monitoring with finger sticks.

After 3 months, there was a significant improvement in glucose levels in both groups, but no between-group differences.

Mild low blood sugar, or hypoglycemia, was ''very common'' in both groups, but reductions in elevated blood sugar in the continuous monitoring group was ''at the cost of increased duration of hypoglycemia.'' The researchers conclude that although continuous monitoring might help certain groups of patients, it does not appear to offer any advantages in reasonably well-controlled outpatients.

Specific groups to target, added Yates, may be diabetics with constantly elevated glucose levels or frequent episodes of hypoglycemia.

REUTERS SB DS1240