Mean amplitude of glycemic excursions in septic patients and its association with outcomes: A prospective observational study using continuous glucose monitoring

2020 ◽  
Author(s):  
Nana Furushima ◽  
Moritoki Egi ◽  
Norihiko Obata ◽  
Hitoaki Sato ◽  
Satoshi Mizobuchi
Keyword(s):  
Observational Study ◽  
Continuous Glucose Monitoring ◽  
Prospective Observational Study ◽  
Glucose Monitoring ◽  
Mean Amplitude

Continuous glucose monitoring in acute stroke

2019 ◽  
Author(s):  
Laura Aponte-Becerra ◽  
Rodrigo Quispe ◽  
Laura Mendez-Pino ◽  
Vera Novak ◽  
Magdy Selim ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Acute Stroke ◽  
Continuous Glucose Monitoring ◽  
Poor Prognosis ◽  
Glucose Monitoring ◽  
Mean Amplitude ◽  
P Value ◽  
Stroke Patients ◽  
Glycaemic Variability ◽  
Acute Brain Ischemia

"Hyperglycaemia upon admission is a pathophysiological response to acute brain ischemia that has been independently associated with high mortality rate and poor prognosis. Glycaemic variability (GV) has also shown association with poor clinical outcomes among stroke patients. GV is best assessed by continuous glucose monitoring (CGM), which enables consecutives glucose measurements every 5 minutes. This pilot study aimed: 1) To describe safety, feasibility and tolerability of CGM in the acute stroke setting; and 2) To compare CGM and conventional FS glucose-based monitoring regimen in terms of their relationship with GUA and the accuracy of hypoglycaemic episodes detection. Safety, feasibility and tolerability of CGM was excellent in our cohort of 23 patients with acute stroke (61% ischemic and 39% intracerebral haemorrhage) and there were no adverse events. CGM recorded ten hypoglycaemic episodes that were not detected by conventional FS monitoring. GUA was associated with coefficient of variation (CV) of CGM (p=0.03), CV of FS (p=0.01), standard deviation (SD) of CGM (p-value=0.01) and mean amplitude of glucose excursions (MAGE) (pvalue= 0.001)."

The Impact of Fasting in Ramadan on Metabolic and Anthropometric Indices in Trained Type ΙΙ Diabetic Patients: A Prospective Observational Study

2020 ◽  
Author(s):  
Tayebe Yazdanyar ◽  
Mehrnoush Sohrab ◽  
Atena Ramezani ◽  
Zahra Kashi ◽  
Parastoo Karimi Ali Abadi ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Observational Study ◽  
Blood Sugar ◽  
Prospective Observational Study ◽  
Eating Habits ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Anthropometric Indices ◽  
Ramadan Fasting

Abstract Background: Fasting has certain effects on metabolic and anthropometric parameters in diabetic patients. It is, therefore, necessary for patients to receive proper education related to their physical activities, eating habits, blood glucose monitoring, and medications. The aim of this study was to investigate the effects of Ramadan fasting on metabolic and anthropometric indices in type ΙΙ diabetic patients.Methods: This prospective observational study was performed during Ramadan 2018. The study population consisted of diabetic patients who desired to fast and received information on physical activity, eating habits, blood glucose monitoring, and taking their medications before Ramadan. Fasting blood sugar (FBS), blood sugar 2-hour postprandial (BS2hpp), glycosylated hemoglobin (HbA1C), and the lipids profile were assessed before and after Ramadan month. FBS and BS2hpp were also evaluated on the fifteenth day of Ramadan. The significance level for data analysis was considered p<0.05.Results: Out of 40 diabetic cases who completed the study, 6 (15%) were male and 34 (75%) were female. The mean age of participants was 55.2 ± 9.3 years. The anthropometric variables, including weight, BMI, waist, and blood pressure, decreased significantly after Ramadan fasting (p<0.05). FBS decreased significantly (125.1 ± 27.4 vs 105.2 ± 21.4, p<0.0001) and serum triglyceride increased significantly (127.5 ± 45.5 vs 166.5±53.5 mg/dl, p<0.001) after fasting compared to pre-Ramadan measurement. Other variables remained unchanged.Conclusion: The results of this study indicate that type II diabetic patients who have controlled blood sugar and received information based on clinical guidelines about their lifestyle and medications can fast safely during the holy month of Ramadan.

P6441New continuous glucose monitoring reveals hypoglycemia risk in both diabetic and nondiabetic patients with acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Kuroda ◽  
M Kawata ◽  
A Matsuura ◽  
K Adachi ◽  
Y Hirayama ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Mean Amplitude ◽  
Glucose Fluctuation ◽  
Glucose Levels ◽  
Interstitial Glucose ◽  
The Mean ◽  
Artery Disease

Abstract Background There has been growing evidence that the glucose fluctuation is an important contributing factor to the development of coronary artery disease. However, whether large glucose fluctuation, especially hypoglycemia, may be associated with acute myocardial infarction (AMI) remains largely unknown. Aim As new continuous glucose monitoring (CGM) has recently become available to evaluate glucose fluctuation from immediately after an emergency visit, this study sought to investigate glucose fluctuation and the occurrence of hypoglycemia in patients with AMI. Methods In this prospective study, 93 consecutive patients with AMI from April 2017 to November 2018 were enrolled. Subcutaneous interstitial glucose levels were monitored from emergency room to discharge using the CGM System. Based on the CGM data, 24-h mean glucose levels, the time in hyperglycemia and hypoglycemia and the occurrence of hypoglycemia, defined as less than 70 mg/dL, were measured, and the mean amplitude of glycemic excursions (MAGE) were calculated. Results The majority of patients [n=57, 61% (non-DM)] did not have diabetes and 36 patients had diabetes (DM). The occurrence of hypoglycemia within 24 hours after admission was observed in 49 patients [DM: n=11 (30.6%), non-DM: n=38 (66.7%)]. MAGE within 24 hours after admission were 100±47 in DM patients and 67±20 in non-DM patients. The mean time in hypoglycemia within 24 hours after admission was 148 minutes [DM: 100±260 minutes, non-DM: 178±287 minutes]. The occurrence of hypoglycemia during a hospital stay (mean 11.5 days) was detected in 76 patients [DM: n=28 (77.8%), non-DM: n=48 (84.2%)]. Representative case of hypoglycemia Conclusion Not only in DM patients but also in non-DM patients with AMI, large glucose fluctuation and high incidence of hypoglycemia were observed using new CGM system. Further investigations should address the rationale for the early detection and control of glucose fluctuation for AMI patients.

scholarly journals Predictive Factors of the Adherence to Real-Time Continuous Glucose Monitoring Sensors: A Prospective Observational Study (PARCS STUDY)

2020 ◽  
pp. 193229682093920
Author(s):  
Takashi Murata ◽  
Akio Kuroda ◽  
Munehide Matsuhisa ◽  
Masao Toyoda ◽  
Moritsugu Kimura ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Prospective Observational Study ◽  
Insulin Infusion ◽  
Glucose Monitoring ◽  
Self Monitoring ◽  
Related Quality ◽  
The Mean ◽  
One Year

Background: Information about factors related to better adherence to continuous glucose monitoring (CGM) sensor adherence is quite limited. Materials and Methods: Forty-six participants with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) without CGM were recruited. The participants’ characteristics and diabetes-related quality of life (QOL) were evaluated at baseline and one year after starting to use CGM. Participants wearing the sensor for ≥60% of the time were considered as adherent. Results: The mean age of the 46 participants was 44.1 ± 15.0 years old and the mean glycohemoglobin (HbA1c) was 7.7 ± 1.0%; 60.9% of the participants were classified as adherent. The duration of using CSII was longer in the adherent group, and the degree of diabetic retinopathy was significantly different. There were no significant differences in age, frequency of self-monitoring of blood glucose, or Hypoglycemia Fear Survey (HFS-B for behavior, HFS-W for worry) score at baseline between the adherent and nonadherent groups. The Problem Areas in Diabetes (PAID) score at baseline was significantly higher and the total CSII-QOL score at baseline was significantly lower in the adherent group. The usage of dual-wave bolus was significantly increased in the adherent group (34.6%-61.5%, P = .016), but not in the nonadherent group (33.3%-33.3%, P > .999). The HbA1c level showed a significant improvement in the adherent group (7.8%-7.3%, P < .001), but not in the nonadherent group (7.5%-7.2%, P = .102). Conclusions: Higher adherence to CGM sensors may be associated with a heavier emotional burden of diabetes and a worse QOL in relation to CSII at baseline.

scholarly journals Significance of day-to-day glucose variability in patients after acute coronary syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Machiko Miyoshi ◽  
Hiroyasu Uzui ◽  
Tomohiro Shimizu ◽  
Takayoshi Aiki ◽  
Yuichiro Shiomi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Continuous Glucose Monitoring ◽  
Disease Onset ◽  
Glucose Monitoring ◽  
Mean Amplitude ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
High Blood Glucose ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Abstract Background Several studies have recently addressed the importance of glycemic variability (GV) in patients with acute coronary syndrome (ACS). Although daily GV measures, such as mean amplitude of glycemic excursions, are established predictors of poor prognosis in patients with ACS, the clinical significance of day-to-day GV remains to be fully elucidated. We therefore monitored day-to-day GV in patients with ACS to examine its significance. Methods In 25 patients with ACS, glucose levels were monitored for 14 days using a flash continuous glucose monitoring system. Mean of daily differences (MODD) was calculated as a marker of day-to-day GV. N-terminal pro-brain natriuretic peptide (NT-proBNP) was evaluated within 4 days after hospitalization. Cardiac function (left ventricular end-diastolic volume, left ventricular ejection fraction, stroke volume) was assessed by echocardiography at 3–5 days after admission and at 10–12 months after the disease onset. Results Of the 25 patients, 8 (32%) were diagnosed with diabetes, and continuous glucose monitoring (CGM)-based MODD was high (16.6 to 42.3) in 17 patients (68%). Although MODD did not correlate with max creatine kinase (CK), there was a positive correlation between J-index, high blood glucose index, and NT-proBNP (r = 0.83, p < 0.001; r = 0.85, p < 0.001; r = 0.41, p = 0.042, respectively). Conclusions In patients with ACS, MODD was associated with elevated NT-proBNP. Future studies should investigate whether day-to-day GV in ACS patients can predict adverse clinical events such as heart failure.

scholarly journals Advances in Understanding Glucose Variability and the Role of Continuous Glucose Monitoring

2010 ◽  
Vol 06 ◽  
pp. 53 ◽  
Author(s):  
Klaus-Dieter Kohnert ◽  
Lutz Vogt ◽  
◽  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Clinical Importance ◽  
Mean Amplitude ◽  
Glucose Variability ◽  
Glycated Haemoglobin ◽  
Data Sets ◽  
Temporal Aspects ◽  
Chronic Hyperglycaemia ◽  
The Impact

Recent data have suggested that glucose variability may add to or modify the risk of diabetes complications. Glycated haemoglobin (HbA1c), an integrated measure of sustained chronic hyperglycaemia, fails to reflect glucose variability and the risks associated with extreme glucose swings. Thus, whether glucose variability should become an integral part of assessing glucose control in clinical practice remains unknown. Since the establishment of continuous glucose monitoring (CGM) systems, various indices of glucose variability and quality of glycaemic control such as the mean amplitude of glycaemic excursions (MAGE) and the Glycaemic Risk Assessment Diabetes Equation (GRADE) can now be precisely computed from CGM data sets. Analysis of CGM data, including the impact of glucose variability and its temporal aspects, has clinical importance and should be incorporated into use in clinical trials and the design of optimal antidiabetes therapies.

scholarly journals Correlation between short- and mid-term hemoglobin A1c and glycemic control determined by continuous glucose monitoring

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jen-Hung Huang ◽  
Yung-Kuo Lin ◽  
Ting-Wei Lee ◽  
Han-Wen Liu ◽  
Yu-Mei Chien ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Hemoglobin A1c ◽  
Glucose Monitoring ◽  
Mean Amplitude ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Before And After ◽  
Patients With Diabetes

Abstract Background Glucose monitoring is vital for glycemic control in patients with diabetes mellitus (DM). Continuous glucose monitoring (CGM) measures whole-day glucose levels. Hemoglobin A1c (HbA1c) is a vital outcome predictor in patients with DM. Methods This study investigated the relationship between HbA1c and CGM, which remained unclear hitherto. Data of patients with DM (n = 91) who received CGM and HbA1c testing (1–3 months before and after CGM) were retrospectively analyzed. Diurnal and nocturnal glucose, highest CGM data (10%, 25%, and 50%), mean amplitude of glycemic excursions (MAGE), percent coefficient of variation (%CV), and continuous overlapping net glycemic action were compared with HbA1c values before and after CGM. Results The CGM results were significantly correlated with HbA1c values measured 1 (r = 0.69) and 2 (r = 0.39) months after CGM and 1 month (r = 0.35) before CGM. However, glucose levels recorded in CGM did not correlate with the HbA1c values 3 months after and 2–3 months before CGM. MAGE and %CV were strongly correlated with HbA1c values 1 and 2 months after CGM, respectively. Diurnal blood glucose levels were significantly correlated with HbA1c values 1–2 months before and 1 month after CGM. The nocturnal blood glucose levels were significantly correlated with HbA1c values 1–3 months before and 1–2 months after CGM. Conclusions CGM can predict HbA1c values within 1 month after CGM in patients with DM.

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