Detecting dysglycaemia in compensated liver cirrhosis: Comparison of oral glucose tolerance test and glycated haemoglobin (HbA1c), with continuous glucose monitoring

2021 ◽  
Author(s):  
Cicely VM Barron ◽  
Helen F Heenan ◽  
Harmony Thompson ◽  
Huan Chan ◽  
Jeffrey Ngu ◽  
...  
Author(s):  
Thomas G. Kontou ◽  
Charli Sargent ◽  
Gregory D. Roach

Continuous glucose monitoring devices measure glucose in interstitial fluid. The devices are effective when used by patients with type 1 and 2 diabetes but are increasingly being used by researchers who are interested in the effects of various behaviours of glucose concentrations in healthy participants. Despite their more frequent application in this setting, the devices have not yet been validated for use under such conditions. A total of 124 healthy participants were recruited to a ten-day laboratory study. Each participant underwent four oral glucose tolerance tests, and a total of 3315 out of a possible 4960 paired samples were included in the final analysis. Bland–Altman plots and mean absolute relative differences were used to determine the agreement between the two methods. Bland–Altman analyses revealed that the continuous glucose monitoring devices had proportional bias (R = 0.028, p < 0.001) and a mean bias of −0.048 mmol/L, and device measurements were more variable as glucose concentrations increased. Ninety-nine per cent of paired values were in Zones A and B of the Parkes Error Grid plot, and there was an overall mean absolute relative difference of 16.2% (±15.8%). There was variability in the continuous glucose monitoring devices, and this variability was higher when glucose concentrations were higher. If researchers were to use continuous glucose monitoring devices to measure glucose concentrations during an oral glucose tolerance test in healthy participants, this variability would need to be considered.


2018 ◽  
Vol 65 (1) ◽  
pp. 45-51 ◽  
Author(s):  
María Clemente León ◽  
Laura Bilbao Gassó ◽  
Antonio Moreno-Galdó ◽  
Ariadna Campos Martorrell ◽  
Silvia Gartner Tizzano ◽  
...  

Author(s):  
Mariana Zorron ◽  
Fernando Marson ◽  
André Morcillo ◽  
Aline Gonçalves ◽  
Mayra de Souza El Beck ◽  
...  

Background and Objectives: Cystic fibrosis-related diabetes is the major comorbidity in cystic fibrosis and reduces life expectancy, highlighting the need for early diagnosis and treatment. This study aimed to verify whether abnormal continuous glucose monitoring results predict cystic fibrosis-related diabetes onset and/or a decline in the forced expiratory volume in the 1st second or body mass index of patients with cystic fibrosis. Methods: Thirty-nine patients with cystic fibrosis (age 10–19 years) were screened for cystic fibrosis-related diabetes using the oral glucose tolerance test. Patients without diabetes diagnose underwent 3 days of continuous glucose monitoring, spirometry and body mass index measurements and were reassessed at the end of the study with a second spirometry, body mass index evaluation and oral glucose tolerance test. Results: Thirty-four patients completed the follow-up (3.1±0.51 years). None of the study variables predicted cystic fibrosis-related diabetes progression or were associated with hypoglycemic events. Continuous glucose monitoring could detect glucose abnormalities not revealed in the oral glucose tolerance test. Patients with glucose level of >140 mg/dL on continuous glucose monitoring showed significantly lower body mass index z scores at both study initiation (-1.55±1.68 vs. -0.17±0.88; p-value=0.02) and completion (-1.65±1.55 vs. -0.42±1.08; p-value=0.039). Conclusions: Continuous glucose monitoring can identify glucose abnormalities not detected by oral glucose tolerance test that are related to early stage decreases in body mass index. However, it was ineffective in predicting the onset of diabetes in this cystic fibrosis population. Different diagnostic criteria for diabetes may be required for individuals with cystic fibrosis.


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