Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Moore raises several questions regarding 2 aspects of the measurements used in our study. The first is the accuracy of the CGMS and its ability to investigate the magnitude of glucose fluctuations. The second is the validity of urinary excretion rates of isoprostanes to investigate the oxidative stress.
None of these methods is perfect for investigating both glucose instability and activation of oxidative stress. Our study was not designed to validate these methods; this has been described in other studies.1,2 The records were validated according to the recommendations of the manufacturer, including satisfactory concordance between glucose sensor values and capillary blood measurements. Because the study was conducted on an ambulatory basis, it was not feasible to have repeated laboratory glucose determinations over 48 hours or to control dietary intake and physical activity. We are not sure that investigation of patients in ward conditions would have been better than studying patients on an ambulatory basis, which has the strong advantage of being more representative of real life.
Monnier L, Mas E, Ginet C, Michel F, Villon L, Cristol J, Colette C. Glucose Fluctuations and Oxidative Stress—Reply. JAMA. 2006;296(14):1730–1731. doi:10.1001/jama.296.14.1730-b