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Vol. 58. Núm. 3.
Páginas 217-221 (marzo 2003)
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Vol. 58. Núm. 3.
Páginas 217-221 (marzo 2003)
Acceso a texto completo
Monitorización continua de glucosa en la diabetes mellitus tipo 1
Continuous glucose monitoring with type 1 diabetes mellitus
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J.P. López-Siguero, M.aJ. García Arias
Autor para correspondencia
majosega@eresmas.com

Correspondencia: Avda. Pío Baroja, 20, 7.º A. 29017 Málaga. España
, A. del Pino de la Fuente, J.A. Moreno Molina
Sección de Endocrinología Pediátrica. Hospital Materno-Infantil. Complejo Hospitalario Carlos Haya. Málaga. España
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Bibliografía
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Estadísticas
Antecedentes

El buen control metabólico de los nios con diabetes mellitus (DM) tipo 1 se basa en deter inaciones frecuentes de glucemia capilar. Este método ofrece una informacin parcial sobre las fluctuaciones de la glucemia, pasando desapercibidos episodios de hiperglucemia posprandiales y de hipoglucemias, principalmente nocturnas. El Continuous Glucose Monitoring System (CGMS?) de Minimed aporta informacin de los valores de glucosa intersticial durante aproximadamente 72 h.

Objetivos

Analizar los valores de glucosa preprandiales y pos-prandiales, presencia y duración de las hipoglucemias, en niños diabéticos mayores de 8 años con más de un año de evolución.

Métodos

Se monitorizaron con CGMS? 17 pacientes con DM tipo 1 de ambos sexos, durante días laborables. La edad media fue de 12 años. Se registraron los valores de gluco-sa preprandial y posprandial máximos (1-3 h) tras el de-sayuno, el almuerzo y la cena. Los datos se descargaron mediante una Comstation.

Resultados

La duración media de monitorización fue de 2,97 días.La media de los valores de glucosa preprandial estuvo entre 144,9 y 160,5 mg%, y los posprandiales entre 230,4 y 248,8 mg%. El número medio de hipoglucemias detectadas con el sensor fue de 4,9 y con glucómetro 1,8 (p < 0,05). Se detectaron hipoglucemias asintomáti-cas, principalmente nocturnas, con duración media de 145 min durante la noche y de 75 min de día.

Conclusiones

La monitorización continua de glucosa intersticial pone de manifiesto que con la terapia insulínica habitual no se alcanzan los objetivos glucémicos y se producen un número elevado de hipoglucemias, la mayoría asintomáticas.

Palabras clave:
Diabetes mellitus tipo 1
Niños
Monitorización continua de glucosa
Hipoglucemia
Background

Appropriate metabolic control of children with type 1 diabetes mellitus (DM) is based on frequent measure-ments of capillary glycemia. However, this method offers only partial information on fluctuations in glycemia dur-ing the day, while episodes of postprandial hyperglycemia and hypoglycemia, mainly nocturnal, go unnoticed.

Objectives

To analyze pre and postprandial blood glucose levels, as well as the presence and duration of hypoglycemic episodes in diabetic children aged more than 8 years old with more than one year of disease duration.

Methods

Seventeen patients of both sexes (mean age: 12 years old) with type 1 DM were monitored with the continuous glucose monitoring system (CGMS?) during working days.Maximum values of pre- and postprandial glucose (1-3 hours after breakfast, lunch and dinner) were registered.Data were downloaded with a Com-station.

Results

The mean duration of sensor-wearing was 2.97 days. Pre-and postprandial values were high: mean preprandial values were between 144.9 and 160.5mg% and mean postprandial values were between 230.4 and 248.8 mg%. The mean num-ber of hypoglycemic episodes detected with the sensor was 4.9 compared with 1.8 detected with the glucometer (p < 0.05). Episodes of mainly nocturnal asymptomatic hy-poglycemia were detected with a mean duration of 145minutes during the night and 75minutes during the day.

Conclusions

The use of continuous subcutaneous glucose monitoring demonstrates that glycemic objectives are not achieved by conventional insulin therapy. It also shows that there are a high number of hypoglycemic episodes, most of which are asymptomatic.

Key words:
Type 1 diabetes mellitus
Children
Continuous glucose monitoring
Hypoglycemia
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Bibliografía
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Copyright © 2003. Asociación Española de Pediatría
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