Impacto do sistema de monitorização contínua da glicose em pacientes diabéticos

Abstract

OBJETIVE. To evaluate the accuracy, safety and complications of the continuous glucose monitoring system (CGMS) in diabetic patients (DM). The impact of this system on metabolic/glycemic control is still under discussion. METHODS. The 53 patients studied (47.2% male / 52.8% female), average age: 29.74±16.38 years, DM1 prevalence (86.8%) were submitted to 72h CGMS (Medtronic; Northridge, CA). Capillary glycemia (CG) and mean CGMS sensor's glycaemic value; correlation coefficient, glycemic excursions (CGMS vs. CG), postprandial hyperglycemia, unrecognized hypoglycemia, complications and therapeutic management after CGMS were analyzed. A1c levels were measured at baseline (1 month before) and after 3 months of the study. RESULTS. The mean capillary glucose values were 191.3±45.6 vs. 192.5±43.9mg/dl by CGMS sensor, with significant correlation (p=0.001). The correlation coefficient was 0.87± 0.16 (VR>0.79). The CGMS was significantly more efficient in the detection of glycemic excursion related to capillary glycemia (p=0.001). Postprandial hyperglycemia was identified in 77.3% of diabetic patients and nocturnal unrecognized hypoglycemia was detected in 54%. Data showed a significantly decreased A1c level, three months after the CGMS (p=0.001). No complications were registered in 89.8% of patients. CONCLUSION. The CGMS was confirmed to be a very safe method, with high accuracy in glycemic values and to have a low complication rate. It is a good method to identify glucose excursion, postprandial hyperglycemia and asymptomatic hypoglycemia, with a significant impact on the A1c levels of diabetic patients.