Introduction: To diagnose the hypoglycemic diseases (HD), firstly, proving the hypoglycemia presence is necessary. For this purpose, the prolonged fast test, which can reach 72 h, is performed. In case of late completion this test has a potential risk of hypoglycemic coma. Repeated glycemia control by glucometer brings discomfort to patients and increases the labor costs of medical workers. In this regard, it was relevant to conduct a study on the comparison of continuous glucose monitoring by portative system (CGMS) in interstitial fluid and regular glucose monitoring by glucometer in capillary blood.
Methods: We performed the fast test in 38 patients aged 1872 years with suspicion of HD. In the ranges of glycemia 2.63.0 and 2.22.5 according to glucometer data and at the time of finishing the test we fixed the glycemia according to CGMS data and took the venous blood. We estimated the CGMS accuracy in relation to venous glycemia and glucometer data: in normoglycemia (venous glycemia more than 3 mmol/l), in hypoglycemia (venous glycemia 3 mmol/l and less). The comparative estimation of financial cost and labor costs (CGMS calibration and glycemia determination by glucometer) was performed. We compared the test duration: actual and hypothetical (provided that completion criteria were determined in accordance with CGMS data - glycemia less than 2.8 mmol/l).
Results: Mean deviation of CGMS indicators compared to laboratory values in normoglycemia is +0.57, in hypoglycemia is +0.9; compared to glucometer: in normoglycemia is +0.14, in hypoglycemia is +0.59. Mean actual test duration in patients with confirmed HD (n=25) is 35.3 h, mean hypothetical test duration is 19.3 h. Mean frequency of CGMS calibration is 2.2 per day, mean frequency of glycemia determination by glucometer is 7.2 per day. Taking into account the cost of in-patient stay in a hospital, sensors for CGMS, test strips for glucometer, the expenses of measuring glucose by CGMS and by glucometer do not differ significantly.
Conclusion: The CGMS accuracy is higher in high glycemia and comparable to a glucometer. Using CGMS has the same financial cost like glucometer using. The CGMS timely warns about glycemia decreasing. CGMS reduces the labor costs and, in certain conditions, decreases the test duration. Doctors can orientate on CGMS indicators given the fact of their overstatement. We need to accumulate data for the final conclusion and recommendations for using CGMS in diagnosis of HD.
Funding: The work was supported by the grant of Russian Science Foundation (project 17-75-30035).
18 - 21 May 2019
European Society of Endocrinology