IMPROVEMENT OF THE COMPLIANCE WITH BLOOD-GLUCOSE MONITORING IN YOUNG INSULIN-DEPENDENT DIABETES-MELLITUS PATIENTS BY THE SENSORLINK(TM) SYSTEM

Recently, Medisense has introduced the Sensorlink(TM) system as a tool for retrieving the 125 last results of home blood glucose monitoring stored in patient's Pen(TM) 2 or Companion(TM) 2, unknown to them. The refore we decided to check the compliance of type I diabetic adolescen ts and young adults with home blood glucose monitoring (HBGM) by compa ring the blood glucose values noted in their log book and those retrie ved by the Sensorlink(TM) and to evaluate an eventual subsequent effec t both on compliance and glycated haemoglobin (HbA(1c)). The study was carried out in 60 insulin-dependent diabetes mellitus (IDDM) patients (33 women and 27 men) chosen according to two criteria: (1) the use o f a Medisense Pen(TM) 2 or Companion(TM) 2; (2) autonomous self-monito ring of blood glucose, i.e. without parental supervision. They were ag ed 21.3 +/- 6.3 years with a diabetes duration of 11.6 +/- 7.0 years. HbA(1c) was measured by an HPLC method (N: 4.4-6.0%) before and after the first use of the Sensorlink(TM) and HBGM data of the log books wer e recorded. After the first use of the Sensorlink(TM), the patients we re warned of the retrieving data. The 60 patients were divided into tw o groups (same mean age and diabetes duration), according to the mean level of HbA(1c) before Sensorlink(TM): less than or equal to 7% (good control; n = 33); > 7% (insufficient control; n = 27). Cheating was u nrelated to sex and occurred in 36 patients (60%; aged: 19.3 +/- 4.7 y ears), up to 100% in 13 of them (22%); five patients had no log book ( 8%; aged: 24.0 +/- 5.0 years); 19 patients (32%; aged 24.4 +/- 7.9 yea rs) didn't cheat at all. After the use of the Sensorlink(TM) system, c heating dramatically decreased to zero. The effect of the Sensorlink(T M) system on improvement of HbA(1c) was statistically significant in t he 27 patients with insufficient control before Sensorlink(TM), since mean HbA(1c) level decreased from 8.0 +/- 0.9% to 7.5 +/- 1.1% (P < 0. 05). In conclusion, non compliance with HBGM occurs in 2/3 of adolesce nts and young adults with IDDM. The Sensorlink(TM) system puts an end to this phenomenon and allows significant reduction of HbA(1c) levels in patients with insufficient metabolic control. (C) 1997 Elsevier Sci ence Ireland Ltd.