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"Wristwatch" monitors may miss low blood sugar
By Megan Rauscher
NEW YORK (Reuters Health) - Recently developed devices, worn on
the arm, continuously monitor blood sugar levels -- a boon for people
with diabetes. Glucose levels that are too high can create long-term
problems, while excessively low levels can lead to disorientation
or even loss of consciousness.
However, findings published in the medical journal Diabetes Care
suggest that the GlucoWatch G2 Biographer (GW2B) and the continuous
glucose monitoring system (CGMS) "do not reliably detect"
low blood glucose levels (i.e., hypoglycemia) in children and adolescents
with type 1 diabetes.
Detecting hypoglycemia is a "critically important" function
of these FDA-approved devices, Dr. Eva Tsalikian and other members
of the Diabetes Research in Children Network (DirecNet) Study Group
note in the paper. Therefore, they assessed the performance of the
two glucose monitors during both spontaneous and induced reductions
in blood glucose.
During a 24-hour stay at a research center, 91 children age 3.5
to 17.7 years wore one or two CGMS devices and 89 of these subjects
wore one or two GW2B devices.
"Our results demonstrate that neither the GW2B nor the CGMS
is accurate with respect to reporting glucose values in the hypoglycemic
range," the investigators report.
For example, when the GW2B alarm level was set for a glucose level
of 60 or lower, it detected hypoglycemia only 23 percent of the
time, while the false-alarm rate was 51 percent.
For the original CGMS device as well as a modified version that
became available in November 2002, the detection rates of true hypoglycemia
were 36 percent and 49 percent, respectively, with false-positive
rates of 63 percent and 58 percent, respectively.
The accuracy of the GW2B and the CGMS is "considerably better"
when reference glucose levels are set over 100, according to the
team.
In comments to Reuters Health, Tsalikian, from the Jaeb Center
for Health Research in Tampa, said: "Both the CGMS and GW2B
are not as accurate during hypoglycemia as during normal and high
blood glucose levels."
While both can be helpful in measuring trends and adjusting insulin
doses accordingly, they are not reliable "as a sentinel for
hypoglycemia."
She and her colleagues expect that future generations of sensors
will perform better in this regard.
SOURCE: Diabetes Care, March 2004.
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