Computerized generation of circadian sensor modal days with continuous glucose monitoring for comparison of various insulin regimens based on insulin giargine in type 1 diabetes

• Published in: International journal of artificial organs Vol. 26; no. 8; pp. 728 - 734
• Main Authors: Howorka, K, Pumprla, J, Gabriel, M, Thoma, H, Schabmann, A
• Format: Journal Article
• Language: English
• Published: 01-08-2003
• ISSN: 0391-3988

Aim: Our aims were (1) to design and standardize a statistical approach for data reduction in continuous glucose monitoring, allowing comparison of Orcadian glycemic patterns in therapeutic subcohorts of patients with type 1 diabetes, and (2) to investigate the applicability of this approach for CGMS registered assessment in clinical study of basal insulin replacement quality with various timings of basal injections (pre-breakfast, dinner, bedtime) of a new insulin analog. Methods: Prospective randomized three-arm parallel study with switch over after 6 months for another 3 months of free choice injection time point (options pre-breakfast; pre-dinner and bedtime) of the new Insulin analog in 16 type 1 diabetic subjects on functional insulin treatment (FIT: basal, prandial and correctional dosages), CGMS registered was used at the end of each follow up period of a clinical study. Representative daily profiles were off-line computed as "arcadian sensor modal days" for each insulin regimen consisting of consecutive means of hourly glucose values. Results: Although the overall quality of glycemic control (HbA IC) for different regimens did not reach statistical differences, CGHS registered displayed slightly divergent maximal swings in the course of glycemia (p=0.04-0.08) and allowed - with delineated data reduction procedure - a reliable between treatment comparison. Conclusion: Off-line computation of "hourly arcadian sensor modal days" for data reduction can be effectively used with CGHS registered for description of circadian glycemic patterns in type 1 diabetes.