scholarly journals Critical Reappraisal of the Time-in-Range: Alternative or Useful Addition to Glycated Hemoglobin?

2019 ◽  
Vol 14 (5) ◽  
pp. 922-927
Author(s):  
Lutz Heinemann ◽  
Guido Freckmann ◽  
Dirk Müller-Wieland ◽  
Monika Kellerer
Keyword(s):  
Glucose Control ◽  
Glycated Hemoglobin ◽  
Glucose Monitoring ◽  
Current Therapy ◽  
Additional Information ◽  
Attractive Option ◽  
Patients With Diabetes ◽  
Glucose Profiles ◽  
Time In Range

The HbA1c value is a well-established parameter used to characterize glucose control. Continuous glucose monitoring (CGM)-derived parameters calculated using daily glucose profiles such as Time-in-Range (TiR) have increasingly been gaining interest for assessing a patient’s current therapy. The question has arisen as to whether TiR could replace HbA1c? Because TiR focuses on the current quality of glucose control during a minimum of 10 to 14 days of CGM use and reflects the variability of glucose concentrations. Time-in-Range could be considered an attractive option for improving diabetes control in patients with diabetes. Due to the lack of established standards for glucose measurements with CGM systems, results from different CGM systems can deviate from each other. Time-in-Range should not be viewed as a replacement for HbA1c, but should be used to deliver valuable additional information.

scholarly journals Glycemic variability and cardiovascular disease in patients with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e002032
Author(s):  
Marcela Martinez ◽  
Jimena Santamarina ◽  
Adrian Pavesi ◽  
Carla Musso ◽  
Guillermo E Umpierrez
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycated Hemoglobin ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Cardiovascular Complications ◽  
Glucose Levels ◽  
Increased Risk ◽  
Patients With Diabetes

Glycated hemoglobin is currently the gold standard for assessment of long-term glycemic control and response to medical treatment in patients with diabetes. Glycated hemoglobin, however, does not address fluctuations in blood glucose. Glycemic variability (GV) refers to fluctuations in blood glucose levels. Recent clinical data indicate that GV is associated with increased risk of hypoglycemia, microvascular and macrovascular complications, and mortality in patients with diabetes, independently of glycated hemoglobin level. The use of continuous glucose monitoring devices has markedly improved the assessment of GV in clinical practice and facilitated the assessment of GV as well as hypoglycemia and hyperglycemia events in patients with diabetes. We review current concepts on the definition and assessment of GV and its association with cardiovascular complications in patients with type 2 diabetes.

scholarly journals Time in range: a new parameter to evaluate blood glucose control in patients with diabetes

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Monica Andrade Lima Gabbay ◽  
Melanie Rodacki ◽  
Luis Eduardo Calliari ◽  
Andre Gustavo Daher Vianna ◽  
Marcio Krakauer ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Control ◽  
Blood Glucose Control ◽  
Patients With Diabetes ◽  
Time In Range

scholarly journals Effect of Using Additional Readers for Flash Glucose Monitoring System on Metabolic Control, Safety, and the Incidence of Complications in Patients With Diabetes Mellitus

2020 ◽  
pp. 193229681990025 ◽  
Author(s):  
Oskar Kublin ◽  
Mariusz Stępień
Keyword(s):  
Quality Of Life ◽  
Metabolic Control ◽  
Online Survey ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Glucose Levels ◽  
Freestyle Libre ◽  
Patients With Diabetes ◽  
Do It Yourself

Background: The FreeStyle Libre is a flash glucose monitoring (FGM) system, and glucose levels are measured when the reader is brought to the sensor. Additional readers allow for the conversion into a continuous glucose monitoring (CGM) system. These transmitters read data from the sensor and send them to a bluetooth-enabled device thanks to which the user acquires glucose measurements automatically. This modification allows the patient to receive alerts when blood glucose values are abnormal. Methods: The study relied on the results of an anonymous online survey conducted among patients with diabetes or their caregivers who use Facebook groups. A total of 132 respondents who met certain criteria (diabetic who use FGM system longer than 3 months, at least 14 days per month) were enrolled in the study. Results: A significant decrease in self-reported glycated hemoglobin levels was found in adults and children using readers (variable: age P = .008; time P < .001), regardless of the age. The use of additional readers was associated with a significant decrease in the number of self-reported episodes of hypoglycemia ( P < .001) and an improvement in the quality of life (based on self-reported limitations in everyday activities, social contacts, work/school, or doing sports). Conclusion: The use of additional readers for FGM system improves the metabolic control of diabetes and the quality of life, and has a positive effect on the safety of treatment. Flash glucose monitoring used together with additional readers operates as a CGM system and seems to be helpful for patients for the monitoring of interstitial levels of glucose; however, they should be careful when they use do it yourself solution.

scholarly journals The influence of quality of life in treatment adherence of diabetic patients: a systematic review

2015 ◽  
Vol 49 (5) ◽  
pp. 839-846 ◽  
Author(s):  
Luana de Fátima Gusmai ◽  
Tatiana de Sá Novato ◽  
Lilia de Souza Nogueira
Keyword(s):  
Quality Of Life ◽  
Treatment Adherence ◽  
Web Of Science ◽  
Glycated Hemoglobin ◽  
Diabetic Patients ◽  
Diabetes Treatment ◽  
Review Of The Literature ◽  
Foot Care ◽  
Patients With Diabetes

AbstractOBJECTIVETo verify the influence of quality of life in treatment adherence of patients with diabetes mellitus.METHODSystematic review of the literature using the databases MEDLINE, CINAHL, Scopus, LILACS, SciELO and Web of Science with studies published between 2003 and 2014 in English, Portuguese or Spanish.RESULTSSix studies were included in the review, three were identified as having better quality of life scores, being related to better adherence to diabetes treatment measured by glycated hemoglobin or characteristics related to diet, exercise, use of medication and foot care. No association was found between quality of life and adherence in two investigations and a study found a negative association between these variables.CONCLUSIONThere is causal relationship between quality of life and adherence with diabetes treatment. It is suggested that psychosocial aspects of patients should be considered by health professionals in the search for better clinical outcomes in diabetes care.

Use of Continuous Glucose Monitoring in Patients with Diabetes Mellitus on Peritoneal Dialysis: Correlation with Glycated Hemoglobin and Detection of High Incidence of Unaware Hypoglycemia

2015 ◽  
Vol 41 (1-3) ◽  
pp. 18-24 ◽  
Author(s):  
Ahad Qayyum ◽  
Tahseen A. Chowdhury ◽  
Elizabeth Ley Oei ◽  
Stanley L. Fan
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Glucose Monitoring ◽  
Glycated Hemoglobin ◽  
Glucose Monitoring ◽  
Diabetic Control ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
High Incidence ◽  
Patients With Diabetes ◽  
Interstitial Glucose

Introduction: Glycated hemoglobin is used to assess diabetic control although its accuracy in dialysis has been questioned. How does it compare to the Continuous Glucose Monitoring System (CGMS) in peritoneal dialysis (PD) patients? Methods: We conducted a retrospective analysis of 60 insulin-treated diabetic patients on PD. We determined the mean interstitial glucose concentration and the proportion of patients with hypoglycemia (<4 mmol/l) or hyperglycemia (>11 mmol/l). Results: The correlation between HbA1c and glucose was 0.48, p < 0.0001. Three of 15 patients with HbA1c >75 mmol/mol experienced significant hypoglycemia (14-144 min per day). The patients with frequent episodes of hypoglycemia could not be differentiated from those with frequent hyperglycemia by demographics or PD prescription. Conclusion: HbA1c and average glucose levels measured by the CGMS are only weakly correlated. On its own, HbA1c as an indicator of glycemic control in patients with diabetes on PD appears inadequate. We suggest that the CGMS technology should be more widely adopted.

scholarly journals FeV1 and BMI influence King’s Sarcoidosis Questionnaire score in sarcoidosis patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Björn Christian Frye ◽  
Laura Potasso ◽  
Erik Farin-Glattacker ◽  
Surrinder Birring ◽  
Joachim Müller-Quernheim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
General Health ◽  
Unknown Origin ◽  
Well Being ◽  
Current Therapy ◽  
Additional Information ◽  
Related Quality ◽  
Assess Quality

Abstract Background Sarcoidosis is granulomatous disease of unknown origin affecting organ function and quality of life. The King’s Sarcoidosis Questionnaire (KSQ) serves as a tool to assess quality of life in sarcoidosis patients with general health and organ specific domains. A German translation has been validated in a German cohort. In this study we assessed, whether clinical parameters influence KSQ scores. Methods Clinical data (e.g. lung function, organ impairment, serological parameters) for the German validation cohort were extracted from clinical charts and investigated by correlation and linear regression analyses. Results KSQ subdomain scores were generally lower in patients with respective organ manifestation or on current therapy. LUNG subdomain was significantly predicted by lung functional parameters, however for general health status, only FeV1 exerted significant influence. GHS was not influenced by serological parameters, but was significantly negatively correlated with body mass index (BMI). KSQ provides additional information beyond lung function, clinical or serological parameters in sarcoidosis patients. Notably, high BMI is significantly negatively associated with patients’ well-being as measured by KSQ-GHS. Conclusion This observation may direct further studies investigating the effect of obesity on sarcoidosis-related quality of life and strategies to intervene with steroid-sparing therapies and measures of life style modifications. Trial registration This study was registered in the German Clinical Trials Register (reference number DRKS00010072). Registered January 2016.

scholarly journals Continuous Glucose Monitoring Devices: Past, Present, and Future Focus on the History and Evolution of Technological Innovation

2020 ◽  
pp. 193229681989939 ◽  
Author(s):  
Olesya Didyuk ◽  
Nicolas Econom ◽  
Angelica Guardia ◽  
Kelsey Livingston ◽  
Ulrike Klueh
Keyword(s):  
Quality Of Life ◽  
Technological Innovation ◽  
Continuous Glucose Monitoring ◽  
Glucose Control ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Glucose Sensors ◽  
Implantable Sensor ◽  
Monitoring Devices

The concept of implantable glucose sensors has been promulgated for more than 40 years. It is now accepted that continuous glucose monitoring (CGM) increases quality of life by allowing informed diabetes management decisions as a result of more optimized glucose control. The focus of this article is to provide a brief overview of the CGM market history, emerging technologies, and the foreseeable challenges for the next CGM generations as well as proposing possible solutions in an effort to advance the next generation of implantable sensor.

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