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Improving epinephrine responses in hypoglycemia unawareness with real-time continuous glucose

The objective of this study was to determine whether real-time continuous glucose monitoring (CGM) with preset alarms at specific glucose levels would prove...

Authors:
Ly, T.; Hewitt, J.; Davey, R. J.; Lim, E. E. M.; Davis, E. A.; Jones, T. W.

Authors notes:
Diabetes Care. 2011;34(1):50-2

Keywords:
Hypoglycemia, epinephryne, unawerness, real-time, Glucose monitoring, adolescents, type 1 diabetes

Abstract:
The objective of this study was to determine whether real-time continuous glucose monitoring (CGM) with preset alarms at specific glucose levels would prove a useful tool to achieve avoidance of hypoglycemia and improve the counterregulatory response to hypoglycemia in adolescents with type 1 diabetes with hypoglycemia unawareness. 

 Adolescents with type 1 diabetes with hypoglycemia unawareness underwent hyperinsulinemic hypoglycemic clamp studies at baseline to determine their counterregulatory hormone responses to hypoglycemia. Subjects were then randomized to either standard therapy or real-time CGM for 4 weeks. The clamp study was then repeated.

The epinephrine response during hypoglycemia after the intervention was greater in the CGM group than in the standard therapy group.

A greater epinephrine response during hypoglycemia suggests that real-time CGM is a useful clinical tool to improve hypoglycemia unawareness in adolescents with type 1 diabetes. .