scholarly journals The Scientific Advisory board resolution: Implementation of intermittently scanned Continuous Glucose monitoring in clinical practice to improve glycemic control

2021 ◽  
Vol 24 (2) ◽  
pp. 185-192
Author(s):  
V. A. Peterkova ◽  
A. S. Ametov ◽  
A. Y. Mayorov ◽  
G. R. Galstyan ◽  
D. N. Laptev ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Data Interpretation ◽  
Advisory Board ◽  
Point Of View ◽  
Diabetic Patients ◽  
Scientific Advisory Board ◽  
Scientific Advisory

The Scientific Advisory Board chaired by Academician of the Russian Academy of Sciences, Peterkova V.A. was held 26 of November in Moscow to discuss the possibilities of continuous glucose monitoring technology (CGM) implementation into routine clinical practice in Russia in order to improve glycemic control in patients with diabetes mellitus (DM).The main aims for Advisory board were to determine the most significant indicators and parameters for CGM to be implemented in practice from a practical point of view of LMWH, necessary for implementation in clinical practice, for different patients groups with diabetes.The following questions and topics were raised within the discussion: the importance of additional indicators beyond glycated hemoglobin (HbA1c) for glycemic control assessment in diabetes patients, CGM positioning in International and Russian clinical guidelines, the accuracy of CGM devises and approaches to its assessment, the role of education programs for diabetic patients, including trainings in correct use and data interpretation and analysis of CGM data obtained, clinical evidence analysis for CGM in randomized trials and real world evidence.

scholarly journals Effect on Glycemic Control by Short- and Long-Term Use of Continuous Glucose Monitoring in Clinical Practice

2011 ◽  
Vol 5 (6) ◽  
pp. 1472-1479 ◽  
Author(s):  
Jenny Anderson ◽  
Stig Attvall ◽  
Lennart Sternemalm ◽  
Aldina Pivodic ◽  
Martin Fahlén ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Short And Long Term

scholarly journals Glycemic Variability Assessed by Continuous Glucose Monitoring and Short-Term Outcome in Diabetic Patients Undergoing Percutaneous Coronary Intervention: An Observational Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Annunziata Nusca ◽  
Angelo Lauria Pantano ◽  
Rosetta Melfi ◽  
Claudio Proscia ◽  
Ernesto Maddaloni ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Troponin I ◽  
Fasting Blood Glucose ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Percutaneous Coronary

Poor glycemic control is associated with unfavorable outcome in patients undergoing percutaneous coronary intervention (PCI), irrespective of diabetes mellitus. However a complete assessment of glycemic status may not be fully described by glycated hemoglobin or fasting blood glucose levels, whereas daily glycemic fluctuations may influence cardiovascular risk and have even more deleterious effects than sustained hyperglycemia. Thus, this paper investigated the effectiveness of a continuous glucose monitoring (CGM), registering the mean level of glycemic values but also the extent of glucose excursions during coronary revascularization, in detecting periprocedural outcome such as renal or myocardial damage, assessed by serum creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and troponin I levels. High glycemic variability (GV) has been associated with worse postprocedural creatinine and NGAL variations. Moreover, GV, and predominantly hypoglycemic variations, has been observed to increase in patients with periprocedural myocardial infarction. Thus, our study investigated the usefulness of CGM in the setting of PCI where an optimal glycemic control should be achieved in order to prevent complications and improve outcome.

scholarly journals Resolution on the results of the first working meeting of the Scientific Advisory Board «Actual problems of glycemic variability as a new criterion of glycemic control and safety of diabetes therapy»

2019 ◽  
Vol 65 (3) ◽  
pp. 204-211
Author(s):  
Mikhail B. Antsiferov ◽  
Gagik R. Galstyan ◽  
Alexey V. Zilov ◽  
Aleksandr Y. Mayorov ◽  
Tatiana N. Markova ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Insulin Therapy ◽  
Total Mortality ◽  
Glycemic Variability ◽  
Advisory Board ◽  
Published Data ◽  
Routine Practice ◽  
Additional Criterion ◽  
Scientific Advisory Board ◽  
Scientific Advisory

June 19, 2018 the meeting of the Scientific Advisory Board took place in Moscow, chaired by Professor G.R. Galstyan, (co-chair – A.V. Zilov) devoted to the discussion of the possibilities of improving the results of treatment of diabetes mellitus (DM) by consideration of «variability of glycemia» (VG) as an additional criterion of the glycemic control effectiveness (especially of insulin therapy) as well as one of the goals of treatment in patients with unstable glycemia. The purpose of the working meeting was to develop a strategy for the introduction of VG as a predictor and an additional criterion in assessing the effectiveness and safety of hypoglycemic therapy to improve the pharmacotherapy of diabetes and reduce cardiovascular and total mortality. Aims: – to conduct a comprehensive data analysis of the relationship between VG and adverse DM outcomes, such as hypoglycemia, micro-and macrovascular complications, cardiovascular and total mortality; – to accumulate and analyze published data and the experience of decrease of VG and improving outcomes of diabetes on the background of different versions of insulin therapy; – to compare existing methods of glycaemia monitoring and VG assessment, their validity and availability in real practice in the context of limited budget; – to analyze the informativeness, clinical and prognostic significance of various parameters of VG assessment and determine their reasonable «minimum» for a comprehensive assessment of VG as a criterion for evaluating the effectiveness of treatment of DM and predictors of negative diabetes outcomes. The following reports were heard during the discussion: Glycemic variability: clinical and prognostic value. Types of glycemic variability. (Alexey V. Zilov, MD, PhD in Medicine, Assistant Professor). Methods of assessment of variability of glycemia in clinical trials and routine practice (Tatiana N. Markova, MD, PhD in Medicine, Professor). Current international and national recommendations on glycemic monitoring (Gagik R. Galstyan, MD, PhD in Medicine, Professor). Peculiarities of glycemic variability and its evaluation among children and adolescents (Alisa V. Vitebskaya, MD, PhD in Medicine).

scholarly journals MON-653 The Effects of DPP IV Inhibitor on Glycemic Variability in Type 2 Diabetic Patients Treated with Twice Daily Premixed Human Insulin

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Florence Hui Sieng Tan ◽  
Chin Voon Tong ◽  
Yueh Chien Kuan ◽  
Bik Kui Lau ◽  
Huai Heng Loh
Keyword(s):  
Glycemic Control ◽  
Glycaemic Control ◽  
Human Insulin ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Diabetic Patients ◽  
Premixed Insulin ◽  
Dpp Iv

Abstract Glycemic variability (GV) is emerging as an exciting therapeutic target for diabetes mellitus (DM) with recent evidences showing association of GV with hypoglycemia risk as well as chronic complications.(1,2) Twice daily human premixed insulin is commonly used in developing countries and Asia for treatment of type 2 DM (T2DM). (3) While more convenient and cost saving, human premixed insulin regime may increase GV due to lesser flexibility and less physiological pharmacokinetic profile. Dipeptidyl peptidase IV inhibitors (DPPIV-I) have been shown to improve GV when used for treatment of T2DM but the effects of DPPIV-I when added on human premixed insulin is limited. We therefore evaluated the changes in GV following addition of DPP IV-I among T2DM patients treated with premixed human insulin with or without metformin therapy. This was a prospective study involving adult patients with T2DM on stable doses of premixed human insulin with or without metformin for at least 3 months from two state hospitals in Malaysia. Blinded continuous glucose monitoring (CGM) were performed at baseline and following 6 weeks of adding Vildagliptin to their insulin regime. A total of 12 patients were recruited (50% male). Mean (SD) age was 55.8 (13) years with mean duration of disease of 14 (6.6) years. The addition of Vildagliptin significantly reduced GV indexes including SD 2.98 (1.17) to 2.33 (0.82), p=0.017; MAGE 6.94 (2.61) to 5.72 (1.87), p=0.018; MAG 1.60 (0.76) to 1.23 (0.48), p=0.009 and M Value 13.96 (13.01) to 6.52 (7.45), p=0.037. In addition there were improvements in terms of parameters for glycemic control. Time spent in optimal glycemic range (4-8 mmol/l) improved from 38.33 (19.69) to 58.17 (5.95) %, p=0.001 with reduction in AUC for hyperglycemia from 2.09 (1.73) to 1.06 (1.09) mmol/day, p=0.010. Hypoglycemia events were infrequent and the reduction in time spent in hypoglycemia [5.92(9.74) to 1.91 (2.54)%, p=0.191] as well as AUC for hypoglycemia [0.03(0.54) to 0.01(0.02) mmol/day, p=0.163] were found although these did not reach statistical significance. We concluded that addition of DPP IV-I to commonly prescribed twice daily premixed human insulin regime in patients with T2DM may improve GV and glycemic control and warrant further exploration. References (1) Gerry Rayman. Glycaemic control, glucose variability and the triangle of diabetes care. Br J Diabetes 2016;16(Suppl1):S3-S6 (2) Boris P. Kovatchev. Metrics for glycaemic control - from HbA1c to continuous glucose monitoring. Nat Rev Endocrinol. 2017 Jul;13(7):425-436 (3) Kalra S, Balhara YP, Sahay BK, Ganapathy B, Das AK. Why is premixed insulin the preferred insulin? Novel answers to a decade-old question. J Assoc Physicians India. 2013 Jan;61(1 Suppl):9-11

scholarly journals Specific aspects of immunotherapy for multiple sclerosis in Switzerland: A structured commentary

2019 ◽  
Vol 3 (1) ◽  
pp. 2514183X1882207 ◽  
Author(s):  
L Achtnichts ◽  
A Chan ◽  
A Czaplinski ◽  
T Derfuss ◽  
R Du Pasquier ◽  
...  
Keyword(s):  
Public Health ◽  
Multiple Sclerosis ◽  
Clinical Practice ◽  
Advisory Board ◽  
Daily Clinical Practice ◽  
European Medicines Agency ◽  
Scientific Advisory Board ◽  
Consensus Recommendations ◽  
Scientific Advisory ◽  
Disease Modifying

More than a dozen substances are meanwhile available for the disease-modifying immunotherapy of multiple sclerosis (MS). However, for some substances, there is a clear difference between approval in Switzerland (Swissmedic) and neighboring countries (European Medicines Agency (EMA)). In addition, limitations imposed by the Swiss Federal Office of Public Health in the specialties list (SL) have significant effects on use in daily clinical practice. In the following, we present consensus recommendations, which were reviewed and agreed upon by the Scientific Advisory Board of the Swiss Multiple Sclerosis Society and the Swiss Neurological Society. We explicitly focus on practice-relevant differences in the approval of MS immunotherapies in Switzerland compared with the EMA area and discuss further limitations (SL) and their impact on the use in clinical practice. Immunotherapies with the same approval in Switzerland and the EMA area and symptomatic therapies are not discussed here.

Sign in / Sign up

Export Citation Format

Share Document