Effect of Miglitol as an Add-On to Bolus Insulin on Postprandial Glycemic Excursions in Type 2 Diabetes Patients Assessed by Continuous Glucose Monitoring

BACKGROUND Continuous glucose monitoring (CGM) uses subcutaneous sensors and records the average interstitial sensor current every 5 min in the recorder; data are subsequently exported to a computer 4 to 7 days later when calibration with self-measured blood glucose is made retrospectively. How middle-aged and older patients perceive the added technology intervention is not clear. OBJECTIVE The study aimed to understand the factors associated with the adoption of new technology in diabetes care, to understand the feelings and behaviors while using it, and to determine the changes in attitudes and behavior after completing the use of the new technology at the 3-month follow-up. METHODS Middle-aged and older type 2 diabetes patients who had received professional continuous glucose monitoring (iPro 2 [Medtronic]) were invited for semistructured in-depth interviews on the day of the CGM sensor removal and at 3 months after CGM-based counseling. A phenomenography approach was used to analyze the interview data. RESULTS A total of 20 type 2 diabetes patients (aged 53 to 72 years, 13 males and 7 females, 4 to 40 years duration of diabetes, mean glycated hemoglobin 8.54% [SD 0.71%]) completed 2 sections of semistructured in-depth interviews. Physician guidance and participant motivation toward problem solving were found to be factors associated with adoption of the device. Participants indicated that technology can be a reminder, a supervisor, and a visualizer of blood glucose, all of which are helpful for disease management. However, CGM is somewhat inconvenient, and some participants also reported that the provision of this new technology might be a hint of disease progression. There was a higher percentage of women compared with men who reported that CGM can be a reminder or a supervisor to help them with diet control. CONCLUSIONS Physician guidance and participants’ degree of motivation are keys to adopting new technology in the case of middle-aged and older adults. Although the CGM sensor may cause inconvenience to patients on their limited body movement when wearing the device, it is helpful for diet control and is an effective behavioral modification tool that offers support, especially in the case of women.

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The Effect of Discontinuing Continuous Glucose Monitoring in Adults with Type 2 Diabetes Treated with Basal Insulin

10.2337/figshare.16607969.v1 ◽

2021 ◽

Author(s):

Grazia Aleppo ◽

Roy W. Beck ◽

Ryan Bailey ◽

Katrina J. Ruedy ◽

Peter Calhoun ◽

...

Keyword(s):

Type 2 Diabetes ◽

Real Time ◽

Continuous Glucose Monitoring ◽

Basal Insulin ◽

Glucose Monitoring ◽

Blood Glucose Monitoring ◽

Time In Range ◽

Bolus Insulin ◽

Design And Methods

Objective: To explore the effect of discontinuing continuous glucose monitoring (CGM) after 8 months of CGM use in adults with type 2 diabetes treated with basal without bolus insulin. Research Design and Methods: Multi-center trial with an initial randomization to either real-time CGM or blood glucose monitoring (BGM) for 8 months, followed by 6 months in which the BGM Group continued to use BGM (N=57) and the CGM Group was re-randomized either to continue CGM (N=53) or discontinue CGM with resumption of BGM for glucose monitoring (N=53). Results: In the group that discontinued CGM, mean time in range 70-180 mg/dL (TIR), which improved from 38% prior to initiating CGM to 62% after 8 months of CGM, decreased after discontinuing CGM to 50% at 14 months (mean change from 8 to 14 months = -12%, 95% CI -21% to -3%, P=0.01). In the group continuing CGM, there was little change in TIR from 8 to 14 months (baseline 44%, 8 months 56%, 14 months 57%; mean change 8 to 14 months = 1%, 95% CI -11% to 12%, P=0.89). Comparing the two groups at 14 months, the adjusted treatment group difference in mean TIR was -6% (95% CI -16% to 4%, P=0.20). Conclusions: In adults with type 2 diabetes treated with basal insulin who had been using real-time CGM for 8 months, discontinuing CGM resulted in a loss of about half of the initial gain in TIR that had been achieved during CGM use.

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Hypoglycemia in type 2 diabetes patients treated with insulin: the advantages of continuous glucose monitoring

Diabetes Mellitus ◽

10.14341/dm2014175-80 ◽

2014 ◽

Vol 17 (1) ◽

pp. 75-80 ◽

Cited By ~ 6

Author(s):

Vadim Valer'evich Klimontov ◽

Alexander Ivanovich Tsiberkin ◽

Olga Nikolaevna Fazullina ◽

Marina Alekseevna Prudnikova ◽

Nadezhda Viktorovna Tyan ◽

...

Keyword(s):

Type 2 Diabetes ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Insulin Regimen ◽

Premixed Insulin ◽

Dipeptidyl Peptidase 4 ◽

Retrospective Data Analysis ◽

Dipeptidyl Peptidase 4 Inhibitors ◽

Bolus Insulin

Aims. To determine the incidence and risk factors for hypoglycemia in elderly insulin-treated type 2 diabetes mellitus (T2DM) patients by means of continuous glucose monitoring (CGM). Materials and Methods. We observed seventy-six hospitalized patients with T2DM, aged 65 to 79 years. Treatment with basal insulin (n=36), premixed insulin (n=12) or basal-bolus insulin regimen (n=28) was followed by metformin (n=44), glimepiride (n=14) and dipeptidyl peptidase-4 inhibitors (n=14). 2-days CGM with retrospective data analysis was performed in all patients. During CGM, three fasting and three 2-h postprandial finger-prick glucose values were obtained daily with portable glucose meter. Results. Hypoglycemia (identified as blood glucose

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