A group of investigators led by Dr Reinhard Zick of the St. Bonifatius Hospital-Medical Clinic in Lingen, Germany, evaluated the ability of a continuous glucose monitoring system (CGMS) to detect hypoglycaemia in patients with type 2 diabetes. A total of 367 patients (mean age 59.2 years) received NPH insulin for 2 weeks (run-in phase) and insulin glargine for 8 weeks (treatment phase). Before and after the treatment phase, 72-hour blood glucose profiles were obtained using the CGMS and conventional self-monitored blood glucose (SMBG) methods. Hypoglycaemia was defined as glucose values of 60mg/dL or less.

The investigators found that hypoglycaemia occurred in 209 patients according to the CGMS (56.9%) and 97 patients according to SMBG (26.4%). Daytime glucose levels were similar regardless of the method of measurement. Nocturnal glucose levels, however, were significantly lower with the CGMS than with SMBG before treatment (130.2mg/dL vs 145.0mg/dL) and after treatment (123.3mg/dL vs 137.3mg/dL). HbA1c levels decreased from 6.9% at the time of screening to 6.67% after treatment (p<0.001).

The investigators concluded that the CGMS can be used in a clinical-trial setting, and may provide additional insights into glucose dynamics and the time spent within the preferred glucose range.

Diabetes Technology & Therapeutics 2007;9:483-92