Is the masked continuous glucose monitoring system clinically useful for predicting hemoglobin A1C in type 1 diabetes?

Abstract:

BACKGROUND:The masked continuous glucose monitoring system (Masked-CGMS) differs from standard CGMSs in three ways: (1) there is no feedback to the user so that no immediate regimen changes can be made; (2) it can only be worn for up to 5 days; and (3) there are no alarms to warn of hyperglycemia or hypoglycemia. Since 2008 masked-CGMS has become popular for identifying reasons that a patient's hemoglobin A1C does not correlate closely with his or her capillary blood glucose measurements. To date only one study addressing the clinical utility of Masked-CGMS for improving A1C in diabetes has been published. No studies are available specifically examining the variability and correlation of Masked-CGMS and A1C. SUBJECTS AND METHODS:We performed 156 Masked-CGMS studies (40 patients studied sequentially a maximum of four times each) in type 1 diabetes patients. We then analyzed the resulting interstitial glucose levels obtained from the Masked-CGMS compared with an A1C measurement performed within 1 week of the Masked-CGMS study. RESULTS:There was a very low correlation between the A1C and the Masked-CGMS-derived mean interstitial glucose level. This statistic did not provide sufficiently predictive information to be clinically useful for changing an individual patient's intensive insulin therapy regimen. CONCLUSIONS:Our data demonstrate that a very weak correlation exists between 5 days of masked CGMS and a concurrently measured A1C level. For the individual type 1 diabetes patient, this relationship would unlikely to be clinically useful in altering the individual's treatment regimen.

journal_name

Diabetes Technol Ther

authors

Duran-Valdez E,Burge MR,Broderick P,Shey L,Valentine V,Schrader R,Schade DS

doi

10.1089/dia.2013.0297

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

292-7

issue

5

eissn

1520-9156

issn

1557-8593

journal_volume

16

pub_type

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