Diabetes Q&A

New Test For Diabetes Monitoring Shows Promise

A recent study showed that the Apparatus for Diabetes Diagnosis coupled with Complex for Insulin Therapy (ADD-CIT) decreases and stabilizes glycaemia better than usual procedures in patients with diabetes and other acute glucose metabolism disorders.

The findings were presented by Dr Vary Coulic on August 11, 2017, at the 5th World Congress on Hepatitis & Liver Diseases in London, England.
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Hypoglycemic episodes and other “yo-yo” events remain problematic in patients with diabetes. However, Coulic and colleagues have previously shown that ADD-CIT with differential temperature (Dt) evaluation dynamics as feedback for pump insulin delivery may be useful in treating acute, life-glucose metabolism alterations threatening alterations in type 1 diabetes.

In their study, Coulic and colleagues evaluated 83 patients with type 1 diabetes, 45 patients with type 2 diabetes, and 66 patients with no known diabetes but who presented with a severe pathology that caused severe, difficult-to-control hyperglycemia. They also investigated Dt in 10 healthy controls. A total of 137 patients were treated with ADD-CIT, while the remaining 67 received usual treatment.

The main inclusion criteria for patients was hyperglycemia greater than 196 mg/dL at admission. Age, sex, and birth weight were similar across all groups. Observation or session duration lasted up to 8 hours. The researchers also conducted usual clinical investigations, including hourly blood glucose measurements.

Results demonstrated a decrease in glycaemia of 30% to 40% in the ADD-CIT group within 2 to 4 hours, and a stable mean glucose level of 200 mg/dL or less. Hypoglycemic episodes were rare, and yo-yo phenomena were not observed. The same result was achieved in controls after 5 to 7 hours, based on glycaemia evaluation only, and hypoglycemic events and frequent yo-yo phenomena were observed.

The researchers found no correlation between Dt and glycaemia. Dt values were negative and were observed mostly in patients with decompensated type 1 diabetes. In patients with type 2 diabetes, Dt values decreased during sessions but rarely reached negative levels. Dt values increased by the end of each successful session, indicating a stopping point during the session, and approached values typically observed in healthy controls.

In some cases, however, Dt values appeared abnormal at the end of a session, while glycaemia remained stable. In these cases, a cautionary glucose injection was administered to correct the situation without affecting glycaemia.

“Though our series were small and not fully matched, the results of the ADD-CIT groups of patients in terms of glycaemia decrease and stabilization were convincingly better than in patients treated using the usual procedure based only on glycaemia measurements,” the researchers concluded.

“This confirms the usefulness of Dt evolution evaluation as a complementary feedback for insulin delivery not only in [type 1 diabetes] patients but also in [type 2 diabetes] and any other patients with acute severe glucose metabolism disorders.”

—Christina Vogt

Reference:

Coulic V. Use of differential temperature evaluation as feedback for insulin delivery monitoring in acute severe (life threatening) glucose metabolism disorders. Paper presented at: 5th World Congress on Hepatitis & Liver Diseases; August 10-12, 2017. London, UK. http://hepatitis.conferenceseries.com/abstract/2017/use-of-differential-temperature-evaluation-as-feedback-for-insulin-delivery-monitoring-in-acute-severe-life-threatening-glucose-metabolism-disorders.