scholarly journals The interrelationships of glycemic control measures: HbA1c, glycated albumin, fructosamine, 1,5-anhydroglucitrol, and continuous glucose monitoring

2011 ◽  
Vol 12 (8) ◽  
pp. 690-695 ◽  
Author(s):  
Roy Beck ◽  
Michael Steffes ◽  
Dongyuan Xing ◽  
Katrina Ruedy ◽  
Nelly Mauras ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Control Measures

Comparison of Glycemic Markers in Chronic Hemodialysis Using Continuous Glucose Monitoring

2017 ◽  
Vol 47 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Maria Divani ◽  
Panagiotis I. Georgianos ◽  
Triantafyllos Didangelos ◽  
Fotios Iliadis ◽  
Areti Makedou ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Standard Of Care ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Poor Glycemic Control ◽  
Area Under Roc Curve ◽  
Average Glucose

Background: Glycated hemoglobin A1c (HbA1c) among diabetic hemodialysis patients continues to be the standard of care, although its limitations are well recognized. This study evaluated glycated albumin (GA) and glycated serum protein (GSP) as alternatives to HbA1c in detecting glycemic control among diabetic hemodialysis patients using continuous-glucose-monitoring (CGM)-derived glucose as reference standard. Methods: A CGM system (iPRO) was applied for 7 days in 37 diabetic hemodialysis patients to determine glycemic control. The accuracy of GA and GSP versus HbA1c in detecting a 7-day average glucose ≥184 mg/dL was evaluated via receiver-operating-characteristic (ROC) analysis. Results: CGM-derived glucose exhibited strong correlation (r = 0.970, p < 0.001) and acceptable agreement with corresponding capillary glucose measurements obtained by the patients themselves in 1,169 time-points over the 7-day-long CGM. The area under ROC curve (AUC) for GA, GSP, and HbA1c to detect poor glycemic control was 0.976 (0.862–1.000), 0.682 (0.502–0.862), and 0.776 (0.629–0.923) respectively. GA levels >20.3% had 90.9% sensitivity and 96.1% specificity in detecting a 7-day average glucose ≥184 mg/dL. The AUC for GA was significantly higher than the AUC for GSP (difference between areas: 0.294, p < 0.001) and the AUC for HbA1c (difference between areas: 0.199, p < 0.01). Conclusion: Among diabetic hemodialysis patients, GA is a stronger indicator of poor glycemic control assessed with 7-day-long CGM when compared to GSP and HbA1c.

scholarly journals The Use of HbA1c, Glycated Albumin and Continuous Glucose Monitoring to Assess Glucose Control in the Chronic Kidney Disease Population Including Dialysis

Nephron ◽  
2020 ◽  
Vol 145 (1) ◽  
pp. 14-19
Author(s):  
Tobias Bomholt ◽  
Therese Adrian ◽  
Kirsten Nørgaard ◽  
Ajenthen G. Ranjan ◽  
Thomas Almdal ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Glycated Haemoglobin ◽  
Time Data ◽  
Precise Estimation ◽  
Patients With Diabetes ◽  
Mean Glucose

<b><i>Background:</i></b> Glycated haemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) has limitations as a glycemic marker for patients with diabetes and CKD and for those receiving dialysis. Glycated albumin is an alternative glycemic marker, and some studies have found that glycated albumin more accurately reflects glycemic control than HbA<sub>1c</sub> in these groups. However, several factors are known to influence the value of glycated albumin including proteinuria. Continuous glucose monitoring (CGM) is another alternative to HbA<sub>1c</sub>. CGM allows one to assess mean glucose, glucose variability, and the time spent in hypo-, normo-, and hyperglycemia. Currently, several different CGM models are approved for use in patients receiving dialysis; CKD (not on dialysis) is not a contraindication in any of these models. Some devices are for blind recording, while others provide real-time data to patients. Small studies suggest that CGM could improve glycemic control in hemodialysis patients, but this has not been studied for individual CKD stages. <b><i>Summary:</i></b> Glycated albumin and CGM avoid the pitfalls of HbA<sub>1c</sub> in CKD and dialysis populations. However, the value of glycated albumin may be affected by several factors. CGM provides a precise estimation of the mean glucose. Here, we discuss the strengths and limitations for using HbA1c, glycated albumin, or CGM in CKD and dialysis population. <b><i>Key Messages:</i></b> Glycated albumin is an alternative glycemic marker but is affected by proteinuria. CGM provides a precise estimation of mean glucose and glucose variability. It remains unclear if CGM improves glycemic control in the CKD and dialysis populations.

878-P: Real-World Data from U.S. Patients Using a Long-Term Implantable Continuous Glucose Monitoring (CGM) System: Age Effect on Glycemic Control

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 878-P
Author(s):  
KATHERINE TWEDEN ◽  
SAMANWOY GHOSH-DASTIDAR ◽  
ANDREW D. DEHENNIS ◽  
FRANCINE KAUFMAN
Keyword(s):  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Real World ◽  
Glucose Monitoring ◽  
Age Effect ◽  
Real World Data ◽  
World Data

2180-PUB: Integration of Continuous Glucose Monitoring in Diabetes Self-Management Education for Type 2 Diabetes Improves Glycemic Control

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2180-PUB
Author(s):  
ADDIE L. FORTMANN ◽  
ALESSANDRA BASTIAN ◽  
CODY J. LENSING ◽  
SHANE HOVERSTEN ◽  
KIMBERLY LUU ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Management Education ◽  
Glucose Monitoring ◽  
Self Management

scholarly journals The effects of professional continuous glucose monitoring as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dulce Adelaida Rivera-Ávila ◽  
Alejandro Iván Esquivel-Lu ◽  
Carlos Rafael Salazar-Lozano ◽  
Kyla Jones ◽  
Svetlana V. Doubova
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Outcome Variable ◽  
Control Group ◽  
Educational Tool ◽  
Study Objective ◽  
Hba1c Levels

Abstract Background The study objective was to evaluate the effects of professional continuous glucose monitoring (CGM) as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes (T2D). Methods We conducted a three-month quasi-experimental study with an intervention (IGr) and control group (CGr) and ex-ante and ex-post evaluations in one family medicine clinic in Mexico City. Participants were T2D patients with HbA1c > 8% attending a comprehensive diabetes care program. In addition to the program, the IGr wore a professional CGM sensor (iPro™2) during the first 7 days of the study. Following this period, IGr participants had a medical consultation for the CGM results and treatment adjustments. Additionally, they received an educational session and personalized diet plan from a dietitian. After 3 months, the IGr again wore the CGM sensor for 1 week. The primary outcome variable was HbA1c level measured at baseline and 3 months after the CGM intervention. We analyzed the effect of the intervention on HbA1c levels by estimating the differences-in-differences treatment effect (Diff-in-Diff). Additionally, baseline and three-month CGM and dietary information were recorded for the IGr and analyzed using the Student’s paired t-test and mixed-effects generalized linear models to control for patients’ baseline characteristics. Results Overall, 302 T2D patients participated in the study (IGr, n = 150; control, n = 152). At the end of the three-month follow-up, we observed 0.439 mean HbA1C difference between groups (p = 0.004), with an additional decrease in HbA1c levels in the IGr compared with the CGr (Diff-in-Diff HbA1c mean of − 0.481% points, p = 0.023). Moreover, compared with the baseline, the three-month CGM patterns showed a significant increase in the percentage of time in glucose range (+ 7.25; p = 0.011); a reduction in the percentage of time above 180 mg/dl (− 6.01; p = 0.045), a decrease in glycemic variability (− 3.94, p = 0.034); and improvements in dietary patterns, shown by a reduction in total caloric intake (− 197.66 Kcal/day; p = 0.0001). Conclusion Professional CGM contributes to reducing HbA1c levels and is an adjuvant educational tool that can improve glycemic control in patients with T2D. Trial registration ClinicalTrials.gov: NCT04667728. Registered 16/12/2020

Effect of Continuous Glucose Monitoring on Glycemic Control in Adults Using Multiple Daily Insulin Injections

2017 ◽  
Vol 41 (5) ◽  
pp. S55-S56
Author(s):  
David Price ◽  
Tonya Riddlesworth ◽  
Roy W. Beck ◽  
Harold A. Wolpert ◽  
Richard M. Bergenstal ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Daily Insulin ◽  
Multiple Daily Insulin Injections
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