Short-term glucose variability in adults with Type 1 diabetes does not differ between insulin pump and multiple daily injection users – a masked continuous glucose monitoring study in clinical practice

2020 ◽  
Vol 46 (2) ◽  
pp. 172-174
Author(s):  
E.S. Scott ◽  
R.T. McGrath ◽  
A.S. Januszewski ◽  
G.R. Fulcher ◽  
A.J. Jenkins
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Practice ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Daily Injection ◽  
Short Term ◽  
Multiple Daily Injection ◽  
Monitoring Study

947-P: Glucose Variability: Insulin Pump vs. Multiple Daily Injection in Type 1 Diabetes Evaluated by Continuous Glucose Monitoring

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 947-P
Author(s):  
ADRIAN E. PROIETTI ◽  
ANDREA V. DAGHERO ◽  
MARIA LUJAN SCAPUZZI ◽  
MARIA L. IGLESIAS ◽  
JUAN PATRICIO NOGUEIRA
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Daily Injection ◽  
Multiple Daily Injection

scholarly journals Improved Time-in-Range over 1 year is Associated with Reduced Albuminuria in Individuals with Sensor-Augmented Insulin Pump-Treated Type 1 Diabetes

2020 ◽  
Author(s):  
Ajenthen G. Ranjan ◽  
Signe V. Rosenlund ◽  
Tine W. Hansen ◽  
Peter Rossing ◽  
Steen Andersen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Controlled Trial ◽  
Daily Injection ◽  
Albumin Creatinine Ratio ◽  
Multiple Daily Injection ◽  
Blood And Urine Samples ◽  
Time In Range ◽  
One Year

<b>Aim:</b> To investigate the association between treatment-induced change in continuous glucose monitored (CGM) time-in-range (TIR) and albuminuria in persons with type 1 diabetes (T1D) treated with sensor-augmented-pumps (SAP). <p><b>Methods: </b><a></a><a>Twenty-six of fifty-five participants with albuminuria and multiple daily injection-therapy (25% females, 51 (46-63) years, HbA<sub>1c</sub> 75 (68-88) mmol/mol [9.0 (8.4-10.4)%], UACR 89 (37-250) mg/g) were in a randomized-controlled trial assigned to SAP-therapy for one year</a>. Anthropometrics, CGM-data, blood and urine samples were collected every three months.</p> <p><b>Results: </b>Mean change (95%-CI) in %TIR was +13.2 (6.2;20.2)%, HbA<sub>1C</sub> was -14.4 (-17.4;-10.5) mmol/mol [-1.3 (-1.6;-1.0)%] and urinary albumin-creatinine-ratio (UACR) was -15 (-38;17)%, all p<0.05. UACR decreased with 19 (10;28)% per 10% increase in %TIR (p=0.04), 18 (1;30)% per 10 mmol/mol decrease in HbA<sub>1C</sub> (p=0.07), and 31% per 10 mmHg decrease in mean arterial pressure (p<0.001).<b></b></p> <b>Conclusion: </b>In this longitudinal study, treatment-induced increase in %TIR was significantly associated with decrease in albuminuria in T1D.

scholarly journals Pharmacotherapy of type1 diabetes in children and adolescents: more than insulin?

2018 ◽  
Vol 9 (5) ◽  
pp. 157-166 ◽  
Author(s):  
Torben Biester ◽  
Olga Kordonouri ◽  
Thomas Danne
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Real Life ◽  
Glucose Monitoring ◽  
Insulin Analogues ◽  
Insulin Pump Therapy ◽  
Daily Injection ◽  
Great Success ◽  
Pump Therapy

For paediatric patients with type 1 diabetes, intensified insulin therapy with either multiple daily injection or insulin pump therapy is currently the only method of treatment. To optimize this therapy, insulin analogues are fixed parts of all therapy regimens. New ultra-rapid insulins seem to be beneficial not only in adults but also in this age group. New developments in long-acting analogues have demonstrated safety and will be regular in paediatrics, we hope, soon. Furthermore, the psychosocial approach for consideration of real-life aspects becomes more the focus of therapeutic regimens and is implemented into international guidelines. Technical improvements, such as continuous glucose monitoring, particularly in combination with pump therapy, support the great success of rapid-acting analogues by reducing hypoglycaemias. Non-insulin agents such as SGLT2-inhibitors show beneficial aspects in people with type 1 diabetes. For outpatient care with these currently off-label-used drugs, special training for measurement of ketones should be imperative.

scholarly journals Is the Consensual Threshold for Defining High Glucose Variability Implementable in Clinical Practice?

2021 ◽  
Author(s):  
Jean-Baptiste Julla ◽  
Pauline Jacquemier ◽  
Guy Fagherazzi ◽  
Tiphaine Vidal-trecan ◽  
Vanessa Juddoo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Practice ◽  
Research Design ◽  
High Glucose ◽  
Coefficient Of Variation ◽  
Calculation Method ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Design And Methods

<b><i>Objective:</i></b> Estimating glucose variability (GV) through within-day coefficient of variation (%CV<sub>w</sub>) is recommended for patients with type-1 Diabetes (T1D). High-GV (hGV) is defined as %CV<sub>w</sub>>36%. However, continuous glucose monitoring (CGM) devices provide exclusively total-CV (%CV<sub>T</sub>). We aimed to assess consequences of this disparity. <p><b><i>Research Design and Methods:</i></b> We retrospectively calculated both %CV<sub>T</sub> and %CV<sub>W </sub>of consecutive T1D patients from their CGM raw data during 14 days. Patients with hGV with %CV<sub>T</sub>>36% and %CV<sub>w</sub>≤36% were called the “inconsistent-GV group”.</p> <p><b><i>Results:</i></b> 104 patients were included. Mean %CV<sub>T</sub> and %CV<sub>w</sub> were 42.4+/-8% and 37.0+/-7.4% respectively (p<0.0001). Using %CV<sub>T</sub>, 81 patients (73.6%) were classified as hGV whereas 59 (53.6%) using %CV<sub>W </sub>(p<0.0001) corresponding to 22 patients (21%) in the “<i>inconsistent-GV</i> population”.</p> <p><b><i>Conclusions:</i></b> Evaluation of GV through %CV in patients with T1D is highly dependent on the calculation method and then must be standardized.</p>

scholarly journals Is the Consensual Threshold for Defining High Glucose Variability Implementable in Clinical Practice?

2021 ◽  
Author(s):  
Jean-Baptiste Julla ◽  
Pauline Jacquemier ◽  
Guy Fagherazzi ◽  
Tiphaine Vidal-trecan ◽  
Vanessa Juddoo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Practice ◽  
Research Design ◽  
High Glucose ◽  
Coefficient Of Variation ◽  
Calculation Method ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Design And Methods

<b><i>Objective:</i></b> Estimating glucose variability (GV) through within-day coefficient of variation (%CV<sub>w</sub>) is recommended for patients with type-1 Diabetes (T1D). High-GV (hGV) is defined as %CV<sub>w</sub>>36%. However, continuous glucose monitoring (CGM) devices provide exclusively total-CV (%CV<sub>T</sub>). We aimed to assess consequences of this disparity. <p><b><i>Research Design and Methods:</i></b> We retrospectively calculated both %CV<sub>T</sub> and %CV<sub>W </sub>of consecutive T1D patients from their CGM raw data during 14 days. Patients with hGV with %CV<sub>T</sub>>36% and %CV<sub>w</sub>≤36% were called the “inconsistent-GV group”.</p> <p><b><i>Results:</i></b> 104 patients were included. Mean %CV<sub>T</sub> and %CV<sub>w</sub> were 42.4+/-8% and 37.0+/-7.4% respectively (p<0.0001). Using %CV<sub>T</sub>, 81 patients (73.6%) were classified as hGV whereas 59 (53.6%) using %CV<sub>W </sub>(p<0.0001) corresponding to 22 patients (21%) in the “<i>inconsistent-GV</i> population”.</p> <p><b><i>Conclusions:</i></b> Evaluation of GV through %CV in patients with T1D is highly dependent on the calculation method and then must be standardized.</p>

scholarly journals Comparison of the effects of lockdown due to COVID-19 on glucose patterns among children, adolescents, and adults with type 1 diabetes: CGM study

2020 ◽  
Vol 8 (2) ◽  
pp. e001664
Author(s):  
Guido Di Dalmazi ◽  
Giulio Maltoni ◽  
Claudio Bongiorno ◽  
Lorenzo Tucci ◽  
Valeria Di Natale ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 1 Diabetes ◽  
Perceived Stress ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Contributing Factors ◽  
Related Factors ◽  
Adolescents And Adults

IntroductionThe COVID-19 pandemic forced the Italian government to issue extremely restrictive measures on daily activities since 11 March 2020 (‘lockdown’), which may have influenced the metabolic control of type 1 diabetes mellitus (T1D). The aims of the study were to investigate continuous glucose monitoring (CGM) metrics in children and adults with T1D during lockdown and to identify their potentially related factors.Research design and methodsWe enrolled 130 consecutive patients with T1D (30 children (≤12 years), 24 teenagers (13–17 years), and 76 adults (≥18 years)) using either Dexcom or FreeStyle LibreCGM>70% during the study period, without hybrid closed-loop insulin pump. CGM metrics during the 20 days before and the 20 days after lockdown were calculated. By telephonic contact, we performed validated physical activity and perceived stress questionnaires.ResultsIn children, significantly lower glucose SD (SDglu) (p=0.029) and time below range (TBR)<54 mg/dL (TBR2) (p=0.029) were detected after lockdown. CGM metrics were comparable in teenagers before and during lockdown. After lockdown, adults improved significantly time in range (TIR) 70–180 mg/dL (p<0.001) and remaining metrics, except percent coefficient of variation and TBR2. In adults, considering the changes in SDglu and TIR occurred before and during lockdown, we identified a group with improved TIR and SDglu who performed more physical activity, one with improved glucose variability who was younger than the other patients, and one with worsened glucose variability who showed higher perceived stress than others.ConclusionIn patients with T1D during lockdown, CGM metrics mostly improved in children and adults, whereas it was unchanged in teenagers. In adults, age, physical activity, and perceived stress may be relevant contributing factors.

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