Evaluation of Glucaemic Response in Subjects with Type 1 Diabetes - Do Continuous Glucose Measurements Reflect the Plasma Glucose?

Specialeforsvar ved Gitte Lerche Aalborg

Titel:Evaluation of Glucaemic Response in Subjects with Type 1 Diabetes - Do Continuous Glucose Measurements Reflect the Plasma Glucose?

Resume: This thesis considers the evaluation of glucaemic response in subjects with type 1 diabetes. The disease is characterised by a persistent elevated level of plasma glucose and therefore patients need treatment with insulin. Data are provided by Novo Nordisk and consist of continuous glucose monitoring measurements and self measured plasma glucose measurements during a 14 day trial period, where subjects are treated with the insulin formulation NovoLog. Data furthermore contain continuous glucose monitoring measurements, self measured plasma glucose measurements and laboratory measurements during a clinical controlled meal test, which conclude the trial period. The main objective of the thesis is to investigate how well continuous glucose measurements reflect the true plasma glucose concentration and compare this ability with the ability of the self measured plasma glucose method. In addition, comparisons between plasma glucose profiles obtained during the meal test and during breakfasts are considered. Analyses based on the continuous glucose measurements are performed using components from functional data analysis. The results show an improvement of the continuous glucose monitoring method compared to what is found in previous studies, however, the continuous glucose measurements are characterised by a large variation, and the ability to predict the plasma glucose is beaten by the self measured plasma glucose method. Furthermore, the results indicate a difference between the plasma glucose profile obtained during the considered meal test and the distribution of the plasma glucose profiles obtained during considered breakfasts.

Vejledere: Helle Sørensen/ Birgitte Biilmann og Per Larsson, Novo Nordisk A/S  
Censor:    Per Brockhoff