Association between Flash Glucose Monitoring and Metabolic Control as well as Treatment Satisfaction in Outpatients With Diabetes Type 1

Author(s):  
Guido Kramer ◽  
Laura Michalak ◽  
Ulrich Alfons Müller ◽  
Christof Kloos ◽  
Christoph Werner ◽  
...  

Abstract Objective The aim of this study was to follow-up people with diabetes type 1 and Flash Glucose Monitoring (FGM) regarding metabolic control and treatment satisfaction. Methods 40 people with diabetes type 1 and FGM use of ≥6 months were included in the study (female 55%, age 50.9 y, diabetes duration 21.9 y, HbA1c 7.4%, 57.6 mmol/mol, insulin pump therapy 32.5%). The number of scans per day and time/frequency of hypoglycaemia (interstitial glucose value ≤3.9 mmol/l) was recorded from 28 days of the glucose readings. Change of treatment satisfaction was assessed with the DTSQc questionnaire at follow-up (range−18 to+18). Results Mean time of follow-up was 1.0±0.4 y. At follow-up, all participants scanned interstitial glucose 11.9±7.7 times/day. Number of self-monitoring of blood glucose decreased from 6.7±4.2 (baseline) to 0.9±1.8 (follow-up) per day (p<0.001). In individuals with baseline HbA1c ≤7.5%, HbA1c increased (from 6.6±0.7% to 7.0±0.4%, p=0.020). On the contrary, in people with HbA1c>7.5%, HbA1c decreased (from 8.2±0.7% to 7.8±0.7%, p=0.001). In all participants, there were no differences regarding insulin dosage (33.8±12.9 vs. 34.6±13.9 IU/day, p=0.679) and number of insulin injections/day (3.9±2.3 vs. 4.0±2.6, p=0.813) between baseline and follow-up. Frequency of symptomatic hypoglycaemia was at baseline 0.3±0.3 events/day and 0.48±0.36 events/day (recognised, symptomatic events) at follow-up, respectively. In addition, 0.26±0.21 unrecognised hypoglycaemic events/day occurred at follow-up. Treatment satisfaction increased by+12.6 points. Conclusions FGM was associated with an enormous increase in treatment satisfaction and slightly improved metabolic control in people with baseline HbA1c>7.5%. The number of capillary glucose measurements decreased significantly.

2018 ◽  
Vol 17 (2) ◽  
pp. 81-88
Author(s):  
Katarzyna Piechowiak ◽  
◽  
Ewelina Politowska ◽  
Paweł Politowski ◽  
Agnieszka Szypowska ◽  
...  

Author(s):  
Elena Dorando ◽  
Thomas Haak ◽  
Dawid Pieper

Abstract Aim The aim of this meta-analysis was to evaluate the impact of continuous glucose monitoring (CGM) systems on short- and long-term glycemic control in children and adolescents diagnosed with diabetes type 1. Methods The review was registered in PROSPERO (CRD42019135152). We partly updated a formerly published systematic review and searched several databases (Ovid MEDLINE, Embase, CENTRAL, and Clinicaltrials.gov) in May 2019. Summary measures were estimated as relative risks (RR) and standardized mean differences (SMD). The primary endpoint of our analysis was frequency of hypoglycemic events. Quality of evidence was evaluated using the GRADE approach. Results Eleven studies with a total number of 818 patients were included in our review. Meta-analyses indicated a potential benefit of CGM systems regarding the relative risk of a severe hypoglycemic event (RR 0.78; 95% CI 0.29 to 2.04) and mean level of HbA1c at end of study (SMD -0.23; 95% CI -0.46 to 0.00). Certainty of evidence for effect estimates of these meta-analyses was low due to risk of selection bias and imprecision of the included studies. Qualitative analyses of the secondary outcomes of user satisfaction and long-term development of blood glucose supported these findings. Conclusion CGM systems may improve glycemic control in children and adolescents diagnosed with diabetes type 1, but the imprecision of effects is still a problem. Only a few studies examined and reported data for pediatric populations in sufficient detail. Further research is needed to clarify advantages and disadvantages of CGM systems in children and adolescents.


2021 ◽  
Vol 14 ◽  
pp. 117955142110137
Author(s):  
Bader Alzahrani ◽  
Saad Alzahrani ◽  
Mussa H Almalki ◽  
Souha S Elabd ◽  
Shawana Abdulhamid Khan ◽  
...  

Background: Glucose variability (GV) is a common and challenging clinical entity in the management of people with type 1 diabetes (T1DM). The magnitude of GV in Saudi people with T1DM was not addressed before. Therefore, we aimed to study GV in a consecutive cohort of Saudis with T1DM. Methods: We prospectively assessed interstitial glucose using FreeStyle® Libre flash glucose monitoring in people with TIDM who attended follow-up in the diabetes clinics at King Fahad Medical City between March and June 2017. Glycemia profile, standard deviation (SD), coefficient of variation (CV), mean of daily differences (MODD), and mean amplitude of glucose excursion (MAGE) were measured using the standard equations over a period of 2 weeks. Results: Fifty T1DM subjects (20 males) with mean age 20.2 ± 6.1 years and mean fortnight glucose 192 ± 42.3 mg/dl were included. The mean SD of 2-week glucose readings was 100.4 ± 36.3 mg/dl and CV was 52.1% ± 13%. Higher levels of glucose excursions were also observed. MODD and MAGE were recorded as 104.5 ± 51.7 and 189 ± 54.9 mg/dl, respectively which is 2 to 4 times higher than the international standards. Higher MODD and MAGE were observed on weekends compared to weekdays (111.3 ± 62.1 vs 98.6 ± 56.2 mg/dl and 196.4 ± 64.6 vs 181.7 ± 52.4 mg/dl, respectively; P ⩽ .001). Conclusion: Higher degree of glycemic variability was observed in this cohort of TIDM Saudis. Weekends were associated with higher glucose swings than weekdays. More studies are needed to explore these findings further.


2014 ◽  
Vol 125 ◽  
pp. S215
Author(s):  
S. Løseth ◽  
E. Stålberg ◽  
S. Lindal ◽  
R. Jorde ◽  
S.I. Mellgren

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