Analysis of Glycemic Improvement in Hemodialysis Patients Based on Time in Range, Assessed by Flash Glucose Monitoring

2021 ◽  
pp. 1-8
Author(s):  
Keyan Hu ◽  
Huifang Peng ◽  
Yujin Ma ◽  
Xuefeng Li ◽  
RuiFeng Bai ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Glucose Monitoring ◽  
Mean Amplitude ◽  
Diagnostic Value ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Characteristic Analysis ◽  
Flash Glucose Monitoring ◽  
Patients With Diabetes ◽  
Standard Difference

<b><i>Introduction:</i></b> This study aimed to investigate the application value of “time in ranges (TIRs)” in dialysis patients with diabetes and summarize the experience of optimizing glycemic control by flash glucose monitoring (FGM) system. <b><i>Methods:</i></b> In this monocentric 2-week pilot study, FGM was applied for 14 days in 57 type 2 diabetes mellitus medically stable patients under maintenance hemodialysis to determine their glycemic improvement. The diagnostic value of TIR versus HbA1c in detecting glucose fluctuations and levels was evaluated using receiver operating characteristic analysis. <b><i>Results:</i></b> Average glucose exhibited stronger association with TIR (<i>r</i> = −0.785, <i>p</i> &#x3c; 0.001) than HbA1c (<i>r</i> = 0.644, <i>p</i> &#x3c; 0.001), and mean amplitude of glycemic excursion (MAGE) had the same conclusion (<i>r</i> = −0.568, <i>p</i> &#x3c; 0.001 for TIR vs. <i>r</i> = 0.423, <i>p</i> = 0.016 for HbA1c). TIR exhibited a higher area under curve than HbA1c in detecting significant derangements in glucose fluctuation, using a 14-day average FGM-derived coefficient of variation &#x3e;36% as the reference standard (difference between areas: 0.237; 95% CI 0.092–0.383, <i>p</i> = 0.001). We found a significant improvement in TIR (58.38 ± 19.42 vs. 46.45 ± 24.42 mmol/L, <i>p</i> &#x3c; 0.001) and a significant decline in MAGE (median 5.64 vs.7.42 mmol/L, <i>p</i> &#x3c; 0.001) compared to the baseline without deterioration of time spent in hypoglycemia. <b><i>Conclusion:</i></b> TIR seems to be feasible and clinically useful for AGP analysis in dialysis patients with diabetes, and FGM can be used to improve glycemic control.

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.

scholarly journals Correlation Between Short- and Mid-Term Hemoglobin A1c and Glycemic Control Determined by Continuous Glucose Monitoring

2021 ◽  
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.

966-P: The Long-Term Impact of a Flash Glucose Monitoring System on Glycemic Control

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 966-P
Author(s):  
ATSUSHI FUJIYA ◽  
TOSHIKI KIYOSE ◽  
TAIGA SHIBATA ◽  
HIROSHI SOBAJIMA
Keyword(s):  
Glycemic Control ◽  
Monitoring System ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Long Term Impact ◽  
Flash Glucose Monitoring System

Flash glucose monitoring in diabetic dogs: a feasible method for evaluating glycemic control

2020 ◽  
Vol 48 (05) ◽  
pp. 330-338
Author(s):  
Florian K. Zeugswetter ◽  
Andrea Sellner
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Feasible Method ◽  
Klinische Relevanz ◽  
Glykämische Kontrolle ◽  
Diabetic Dogs

Zusammenfassung Gegenstand und Ziel Zur Reduktion der klinischen Symptome und zur Verhinderung von lebensbedrohlichen Komplikationen sind bei Hunden mit Diabetes mellitus individualisierte Behandlungsstrategien und regelmäßige Kontrollen notwendig. Sieben bis 14 Tage nach jeder Anpassung der Insulindosierung und danach monatlich wird das Erstellen von Blutglukose-Tagesprofilen empfohlen. Im Jahr 2016 wurde ein herstellerkalibriertes Gerät zur kontinuierlichen Glukosemessung als Alternative zur Messung mittels Glukometer vorgeschlagen. Ziel dieser Arbeit war, die Erfahrungen mit dieser neuen Technologie zusammenzufassen und zu zeigen, dass bereits die erste Messperiode in Kombination mit einfachen Regeln eine Verbesserung der glykämischen Kontrolle ermöglicht. Material und Methoden Das elektronische Datensystem der endokrinen Einheit der Klinik wurde retrospektiv auf diabetische Hunde mit Flash-Glukose-Monitoring durchsucht. Bei multipler Sensorapplikation fand nur der erste Sensor Berücksichtigung. Die Aufzeichnungen von Tag A (1. Tag nach Sensorapplikation) wurden mit den Werten von Tag B (letzter Tag vor dem Sensorversagen) verglichen und alle Besitzer wurden gebeten, einen standardisierten Fragebogen auszufüllen. Ergebnisse In die Studie wurden 24 Hunde mit einem Gewicht von 3,4 bis 36 kg eingeschlossen. Obwohl das Klickgeräusch bei der Platzierung des Sensors die meisten Hunde irritierte, beurteilten Anwender die Applikation als einfach und für die Hunde schmerzlos. Eine kurze Pause nach der lokalen Desinfektion und die Fixierung des Sensors mit einer Pinzette verhinderten ein vorzeitiges Ablösen des Sensors beim Wegziehen des Applikators. Obwohl bei 80 % der Hunde milde bis moderate Hautirritationen beobachtet wurden, waren 95 % der Besitzer mit dieser Form des Monitorings hoch zufrieden. Die mittleren und maximalen Glukosekonzentrationen (p = 0,043, p = 0,003) sowie die Glukosewerte ≥ 11,1 mmol/l (p = 0,032) nahmen von Tag A zu Tag B ab, während die Parameter der glykämischen Variabilität unverändert blieben. Schlussfolgerung und klinische Relevanz Flash-Glukose-Monitoring ist eine praktikable, nebenwirkungsarme Methode mit hoher Besitzerzufriedenheit, mit der sich die glykämische Kontrolle bei diabetischen Hunden verbessern lässt.

scholarly journals Proposed Use of Continuous Glucose Monitoring for Care of Critically Ill COVID-19 Patients

2020 ◽  
Vol 15 (1) ◽  
pp. 174-176
Author(s):  
Ivana Jankovic ◽  
Marina Basina
Keyword(s):  
Glycemic Control ◽  
Critically Ill ◽  
Effective Means ◽  
Glucose Monitoring ◽  
Protective Equipment ◽  
Nursing Time ◽  
Resource Limitations ◽  
Risk Of Mortality ◽  
Patients With Diabetes ◽  
Continuous Glucose Monitors

Coronavirus disease 2019 (COVID-19) has disproportionately affected patients with diabetes. Mounting evidence has shown that adequate inpatient glycemic control may decrease the risk of mortality. In critically ill patients, insulin drips are the most effective means of controlling blood glucose. However, resource limitations such as the availability of protective equipment and nursing time have discouraged the use of insulin drips during COVID-19. In this commentary, we review existing evidence on the importance of glycemic control in COVID-19 patients with diabetes and propose a protocol for utilizing continuous glucose monitors (CGMs) to improve glycemic control by decreasing the need for bedside management in critically ill COVID-19 patients.

scholarly journals Effect of 6 Months of Flash Glucose Monitoring in Youth With Type 1 Diabetes and High-Risk Glycemic Control: A Randomized Controlled Trial

Diabetes Care ◽  
2020 ◽  
Vol 43 (10) ◽  
pp. 2388-2395 ◽  
Author(s):  
Sara E. Boucher ◽  
Andrew R. Gray ◽  
Esko J. Wiltshire ◽  
Martin I. de Bock ◽  
Barbara C. Galland ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Type 1 Diabetes ◽  
High Risk ◽  
Glycemic Control ◽  
Controlled Trial ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Randomized Controlled
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