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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 . . . [Full Text of this Article]

Louis Monnier, MD
l-monnier@chu-montpellier.fr
Department of Metabolic Diseases
Lapeyronie Hospital

Emilie Mas, PhD
University Institute of Clinical Research
University of Montpellier

Christine Ginet, MD
Department of Metabolic Diseases
Lapeyronie Hospital

Françoise Michel, MD
University Institute of Clinical Research
University of Montpellier

Laetitia Villon, MD
Department of Metabolic Diseases
Lapeyronie Hospital

Jean-Paul Cristol, MD; Claude Colette, PhD
University Institute of Clinical Research
University of Montpellier
Montpellier, France

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