Background: Continuous glucose monitoring (CGM) systems are an emerging technology that allows frequent glucose monitoring in real time.
Objective and hypotheses: To assess the value of using CGM system (Medtronic) versus oral glucose tolerance (OGT) and HbA1c in the diagnosis of glycemic abnormalities (Prediabetes) in high-risk groups.
Methods: We performed OGT and monitored glucose for 72 h using CGMS combined with four to five times/day SGM (before three meals and mid-night) and measured HbA1c concentration in three groups of children and adolescents with high-risk to develop glycemic abnormalities including: ten with morbidly obesity, 16 with thalassemia major (on repeated blood transfusion and iron chelation) and ten with nephrotic syndrome on high dose glucocorticoids for 4 weeks or more as well as ten normal children (controls). The diagnosis of glycemia status whether normal, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) (2 h after oral glucose load in the OGTT or after a CGMS recording) diabetic (DM), was done according to the American diabetes association criteria.
Results: Glycemic abnormalities detected in all groups are summarized in Table. None of the children and adolescents had elevated HbA1c level >5.7%. CGMS diagnosed more glycemic abnormalities in the three high-risk groups compared to OGTT (Table 1).
Conclusion: Our data suggest CGMS is more sensitive method to diagnose glycemic abnormalities (Prediabetes) in high risk patients compared to OGTT and HbA1c. Further studies are required to improve the criteria of early diagnosis of glycemic abnormalities using CGMS.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology