scholarly journals Usefulness of the Continuous Glucose Monitoring (Freestyle Device) to Assess Glycemic Control of Diabetic Patients With and Without COVID 19 in a Hospital of Bogotá Colombia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A352-A352
Author(s):  
Adriana Medina ◽  
Luz Amaya Veronesi
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glycemic Index ◽  
Insertion Site ◽  
Healthcare Providers ◽  
Glucose Monitoring ◽  
Diabetic Patients ◽  
San Jose ◽  
Time In Range ◽  
Student Distribution ◽  
The Mean

Abstract In the context of the COVID19 pandemic, diabetes mellitus constitutes a main risk factor that increases overall mortality (1). The continuous glucose monitoring system (CGM) is an alternative that allows strict glucose monitoring and reduces the contact of the healthcare providers with the patients in the pandemic era. We conducted a study using CGM in COVID vs non-COVID patients hospitalized at the San José Hospital in Bogotá Colombia. Methods: Single center, prospective study of glucose monitoring in patients with and without COVID19 using the Freestyle system. We included patients of 18 years and older, hospitalized at Hospital San José de Bogotá, with diagnosis of diabetes and treated with insulin. We used the T student distribution to analize the data. Primary outcomes were the usefulness of the device in inpatients, and the clinical outcomes according to glucometric measures in patients with and without COVID19 infection. Results: CGM devices were placed on 30 patients: 10 with, and 20 without COVID. The system was feasible with good nurse acceptance. The age of the patients was between 18 and 90 years. Of the COVID positive patients, 30% required ICU and 10% died, the mean HBA1C was 9.5% (CI 95% 7.5–10.09%) with a general variability of 35.6%, only 3 patients archieved goals of time in range. The general glycemic index was 7.04% (CI 0.66-0.100)Of the non COVID patients, 10% required ICU and 10% died, the average variability was 30.9% and hypoglycemic episodes predominated in 3 patients. The general glycemic index was 6.6% (CI 0.61–0.71)The patients who required ICU had an average HBA1C of 10.4%, 80% received corticosteroid management during the hospital stay. No patient had skin or soft tissue infection at the sensor insertion site. Conclusions: During the COVID-19 pandemic, CGM is a useful method for glucometric control that reduces the contact of healthcare providers and allows early interventions to improve metabolic control. Worse outcomes are seen in patients with higher variability and with COVID infection. References: 1. Apicella M. Campopiano MC. Mantuano M. Mazoni L. Coppelli A. Del Prato S. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol.2020: 8; 782–92.

Decreased complexity of glucose dynamics in diabetes: evidence from multiscale entropy analysis of continuous glucose monitoring system data

2014 ◽  
Vol 307 (2) ◽  
pp. R179-R183 ◽  
Author(s):  
Jin-Long Chen (陳錦龍) ◽  
Pin-Fan Chen (陳品汎) ◽  
Hung-Ming Wang (王鴻銘)
Keyword(s):  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Continuous Glucose Monitoring System ◽  
Multiscale Entropy ◽  
Diabetic Patients ◽  
Control Subjects ◽  
Complexity Index ◽  
The Mean ◽  
Glucose Dynamics

Parameters of glucose dynamics recorded by the continuous glucose monitoring system (CGMS) could help in the control of glycemic fluctuations, which is important in diabetes management. Multiscale entropy (MSE) analysis has recently been developed to measure the complexity of physical and physiological time sequences. A reduced MSE complexity index indicates the increased repetition patterns of the time sequence, and, thus, a decreased complexity in this system. No study has investigated the MSE analysis of glucose dynamics in diabetes. This study was designed to compare the complexity of glucose dynamics between the diabetic patients ( n = 17) and the control subjects ( n = 13), who were matched for sex, age, and body mass index via MSE analysis using the CGMS data. Compared with the control subjects, the diabetic patients revealed a significant increase ( P < 0.001) in the mean (diabetic patients 166.0 ± 10.4 vs. control subjects 93.3 ± 1.5 mg/dl), the standard deviation (51.7 ± 4.3 vs. 11.1 ± 0.5 mg/dl), and the mean amplitude of glycemic excursions (127.0 ± 9.2 vs. 27.7 ± 1.3 mg/dl) of the glucose levels; and a significant decrease ( P < 0.001) in the MSE complexity index (5.09 ± 0.23 vs. 7.38 ± 0.28). In conclusion, the complexity of glucose dynamics is decreased in diabetes. This finding implies the reactivity of glucoregulation is impaired in the diabetic patients. Such impairment presenting as an increased regularity of glycemic fluctuating pattern could be detected by MSE analysis. Thus, the MSE complexity index could potentially be used as a biomarker in the monitoring of diabetes.

scholarly journals Bacterial strains colonizing the sensor electrodes of a continuous glucose monitoring system in children with diabetes

2020 ◽  
Author(s):  
Sebastian Seget ◽  
Ewa Rusak ◽  
Mirosław Partyka ◽  
Ewa Samulska ◽  
Aleksandra Pyziak-Skupień ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Insertion Site ◽  
Glucose Monitoring ◽  
Coagulase Negative Staphylococcus ◽  
Diabetic Patients ◽  
Microbiological Analysis ◽  
Older Children ◽  
Bacterial Strains ◽  
Coagulase Negative Staphylococci ◽  
Therapeutic Decisions

Abstract Introduction The higher frequency of infections in diabetic patients is caused by a hyperglycemic environment, which promotes immune dysfunction. People with diabetes are more prone to skin infections. A continuous glucose monitoring (CGM) system provides information on changes in blood glucose (BG) levels throughout the day. Its use facilitates optimal therapeutic decisions for a diabetic patient. One of the factors limiting the use of CGM is inflammation at the insertion site. Aim of the study The aim of the study was the microbiological identification of the bacterial strains which are found on CGM sensor electrodes. Material and methods We performed microbiological tests on patients′ CGM Enlite Medtronic electrodes, which were removed after 6 days of usage according to the manufacturer′s instructions. 31 sensors were examined from 31 children (14 girls) aged from 0.5 to 14.6 years. The microbiological analysis was routinely performed at the Department of Children’s Diabetology Medical University of Silesia in Katowice, Poland. Results 12 (39%) of the electrodes were colonized. In 11 (92%) cases the electrodes were colonized by one bacteria strain. 7 times methicillin-sensitive coagulase negative staphylococcus (MSCNS) was detected. We also found one case of Klebsiella pneumoniae, Ochrobactrum tritici, Bacillus sonorensis and methicillin-resistant coagulase-negative Staphylococci (MRCNS) colonization. One electrode was colonized by the mixed flora Enterococcus faecalis, methicillin-susceptible coagulase-negative Staphylococci (MSCNS), Pseudomonas stutzeri, methicillin-susceptible Staphylococcus aureus (MSSA). The median HbA1c in the group with colonization of electrodes was 6, 85% (6, 3–7, 6%) versus 6, 3% (5, 8–7, 5%) in the group without colonization. The median BMI in the group with colonization of the electrodes was 17.10 kg/m2 (16.28–18.62 kg/m2) versus 15.98 kg/m2 (15.14–17.96 kg/m2) in the group without colonization. Statistically, significantly more frequently electrodes are colonized in older children (median age in the group with colonization of electrodes 11.43 years (6.52–12.27 years), without colonization 8.42 years. (3.098–9.375 years); (p = 0.033). Conclusions It seems that older children are more likely to have their sensor electrode colonized by bacterial strains.

Increased Time-in-Range with Sotagliflozin as Adjunct Therapy to Insulin in Adults with Type 1 Diabetes as Demonstrated by 24-Week Continuous Glucose Monitoring (inTandem1, inTandem2)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1179-P ◽  
Author(s):  
THOMAS DANNE ◽  
BERTRAND CARIOU ◽  
JOHN B. BUSE ◽  
SATISH K. GARG ◽  
JULIO ROSENSTOCK ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Adjunct Therapy ◽  
Time In Range

scholarly journals Enlarged glycemic variability in sulfonylurea-treated well-controlled type 2 diabetics identified using continuous glucose monitoring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fumi Uemura ◽  
Yosuke Okada ◽  
Keiichi Torimoto ◽  
Yoshiya Tanaka
Keyword(s):  
Glucose Level ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
High Dose ◽  
Type 2 Diabetics ◽  
Time In Range ◽  
The Difference ◽  
Glycated Hemoglobin Level

AbstractTime in range (TIR) is an index of glycemic control obtained from continuous glucose monitoring (CGM). The aim was to compare the glycemic variability of treatment with sulfonylureas (SUs) in type 2 diabetes mellitus (T2DM) with well-controlled glucose level (TIR > 70%). The study subjects were 123 patients selected T2DM who underwent CGM more than 24 h on admission without changing treatment. The primary endpoint was the difference in glycemic variability, while the secondary endpoint was the difference in time below range < 54 mg/dL; TBR < 54, between the SU (n = 63) and non-SU (n = 60) groups. The standard deviation, percentage coefficient of variation (%CV), and maximum glucose level were higher in the SU group than in the non-SU group, and TBR < 54 was longer in the high-dose SU patients. SU treatment was identified as a significant factor that affected %CV (β: 2.678, p = 0.034). High-dose SU use contributed to prolonged TBR < 54 (β: 0.487, p = 0.028). Our study identified enlarged glycemic variability in sulfonylurea-treated well-controlled T2DM patients and high-dose SU use was associated with TBR < 54. The results highlight the need for careful adjustment of the SU dose, irrespective of glycated hemoglobin level or TIR value.

scholarly journals Assessment of Hyperglycemia, Hypoglycemia and Inter-Day Glucose Variability Using Continuous Glucose Monitoring among Diabetic Patients on Chronic Hemodialysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4116
Author(s):  
Maria Divani ◽  
Panagiotis I. Georgianos ◽  
Triantafyllos Didangelos ◽  
Vassilios Liakopoulos ◽  
Kali Makedou ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Area Under The Curve ◽  
Glucose Variability ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Diabetic Patients ◽  
Lower Efficiency ◽  
Target Glucose

Continuous glucose monitoring (CGM) facilitates the assessment of short-term glucose variability and identification of acute excursions of hyper- and hypo-glycemia. Among 37 diabetic hemodialysis patients who underwent 7-day CGM with the iPRO2 device (Medtronic Diabetes, Northridge, CA, USA), we explored the accuracy of glycated albumin (GA) and hemoglobin A1c (HbA1c) in assessing glycemic control, using CGM-derived metrics as the reference standard. In receiver operating characteristic (ROC) analysis, the area under the curve (AUC) in diagnosing a time in the target glucose range of 70–180 mg/dL (TIR70–180) in <50% of readings was higher for GA (AUC: 0.878; 95% confidence interval (CI): 0.728–0.962) as compared to HbA1c (AUC: 0.682; 95% CI: 0.508–0.825) (p < 0.01). The accuracy of GA (AUC: 0.939; 95% CI: 0.808–0.991) in detecting a time above the target glucose range > 250 mg/dL (TAR>250) in >10% of readings did not differ from that of HbA1c (AUC: 0.854; 95% CI: 0.699–0.948) (p = 0.16). GA (AUC: 0.712; 95% CI: 0.539–0.848) and HbA1c (AUC: 0.740; 95% CI: 0.570–0.870) had a similarly lower efficiency in detecting a time below target glucose range < 70 mg/dL (TBR<70) in >1% of readings (p = 0.71). Although the mean glucose levels were similar, the coefficient of variation of glucose recordings (39.2 ± 17.3% vs. 32.0 ± 7.8%, p < 0.001) and TBR<70 (median (range): 5.6% (0, 25.8) vs. 2.8% (0, 17.9)) were higher during the dialysis-on than during the dialysis-off day. In conclusion, the present study shows that among diabetic hemodialysis patients, GA had higher accuracy than HbA1c in detecting a 7-day CGM-derived TIR70–180 < 50%. However, both biomarkers provided an imprecise reflection of acute excursions of hypoglycemia and inter-day glucose variability.

scholarly journals Low-Glycemic-Index Sugar in Type 2 Diabetic Patients: A Randomized Controlled Study

2021 ◽  
Author(s):  
Damien Steciuk ◽  
Samia Mahmood Hafez Amir ◽  
Muzzammil Hosenally ◽  
Aroushini Goorapah
Keyword(s):  
Blood Sugar ◽  
Glycemic Index ◽  
Glucose Monitoring ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Sugar Levels ◽  
Type 2 Diabetic ◽  
Low Glycemic Index

Abstract Background and Objectives: There is a need to re assess the value of low-GI food and its specific components. The effect of one of them, namely low-glycemic-index sugar, is unclear, as its impact is usually confounded when reported in the literature. This study attempts to breach this gap, shedding light on its effect in type 2 diabetic patients and evaluate if it could be considered as part of a dietary plan.Subjects and Methods: The blood sugar level of twenty (20) type 2 diabetics was monitored using a Continuous Glucose Monitoring system during two phases; firstly, an initial period of 5 days, whereby all the included patients were taking their usual dietary meals. Subjects were then randomized into two groups of equal size before embarking on a second phase; 10 subjects were instructed to eat prepared, portioned and delivered meals, the difference for the second group being that low-GI sugar was used for the preparation. Results: Compared to baseline (day 1), blood sugar dropped by 18% for the group with low-GI sugar and 13% for those who consumed sugar with a normal-GI. The variation in sugar levels was also more contained in the interventional group. A by-product of the study design shows that constant glucose monitoring could raise awareness, and may foster reduction in blood sugar levels. Portioned food was capable of reducing blood sugar levels, with elevated levels of compliance just after start. Conclusions: Even though the ultimate aim is to reduce sugar consumption by diabetic patients, the intake of a low-GI sugar seems to be less harmful than normal sugar. Compared to using normal sugar for the preparation of portioned foods, the use of a low-GI sugar is encouraged as part of a wider plan for the management of diabetic patients.

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