High frequency of unrecognized hypoglycaemias in patients with Type 2 diabetes is discovered by continuous glucose monitoring.

AIMS: To evaluate the use of a CGMS in the detection of hypoglycaemia in people with type 2 diabetes as an outpatient procedure.
METHODS: 31 type 2 diabetic patients underwent glucose monitoring by means of CGMS (Medtronic MiniMed) for up to three days. Patients took part in at least four SMBG (self monitoring blood glucose) tests per day. After three days of monitoring, the CGMS data was downloaded and analysed by a physician to identify the frequency of hypoglycaemias (< or =50 mg/dl) and borderline values (51-70 mg/dl), their duration and distribution. Findings were discussed with the patient and if necessary treatment was adjusted. Eight weeks later, monitoring was repeated to asses the effects of the adjusted treatment.
RESULTS: Average duration of sensor wear was 4.19 days. Correlation between the sensor and the SMBG readings was high. A high number of hypoglycaemias and borderline values were detected by the CGMS, most of them unrecognized by the patient. The frequency of hypoglycaemias and borderline values just as the duration could be significantly reduced from first to second monitoring.
CONCLUSION: Using the CGMS in type 2 diabetic patients achieved the detection of numerous hypoglycaemias and borderline values both nocturnal and/or unnoticed. The CGMS provides accurate data, which cannot be achieved by conventional SMBG tests. That opens the possibility for treatment adjustment and improvement in metabolic control. For patients it provides a better understanding of the effects of insulin or oral agents, nutrition and exercises to their glucose level.