If results of self-monitoring done before meals and at bedtime are in the target range, then overall glucose control is adequate. Right? Maybe not.

A study of a new continuous monitoring device in children with type 1 diabetes found frequent and profound episodes of both hypoglycemia and postprandial hyperglycemia, even when HbA1c levels were satisfactory and pre-meal glucose levels were near the target range. Researchers at Yale found that almost 90% of the peak glucose levels after every meal were above target (more than 180 mg/dl), and half of them were higher than 300 mg/dl. The continuous monitoring also revealed asymptomatic hypoglycemia in almost 70% of the children.

Noting that this new device has enabled examination of the limitations of conventional monitoring, the study authors suggest that repeated use of the continuous monitor may help to optimize insulin dosing.

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