Title: 
The role of retrospective continuous glucose monitoring system in a deaf type 1 diabetic patient education

Abstract: 
This case presentation shows the benefit of retrospective continuous glucose monitoring system (CGMS) in a deaf diabetic patient with anxious fear of hyperglycaemia and chronic complications. 53-year old female has late onset type 1 diabetes since the age of 35. She has been treated with basal-bolus insulin regimen. One year ago a diabetic retinopathy has been diagnosed. Afterwards she has developed anxious fear of hyperglycaemia. She started overcorrecting blood glucose. When blood glucose level increased above 8 mmol/L, she would have already injected additional correction bolus. Consequently she has experienced many episodes of hypoglycaemia, including severe ones. Her last HbA1c value was 6.0 %. In addition, she is deaf since her birth, which represents an important barrier in the education. In order to reduce further anxiety of hyperglycaemia and prevent the patient from overcorrecting, retrospective CGMS was introduced as an educational tool. The sign language interpreter was also included in the education program. After interpretation of only 6-day retrospective CGMS data the patient was persuaded not to overcorrect. In the following three weeks the frequency of hypoglycaemic episodes was reduced by 72%. There were no episodes of severe hypoglycaemia. At the same time, there were no overt hyperglycaemic episodes in that period of time. Patient also reported of improved life quality and reassurance. In conclusion, deaf type 1 diabetic patients with anxious fear of hyperglycaemia can benefit from transient retrospective continuous glucose monitoring used as an educational tool.