979-P: Lower Glucose Thresholds for Hyperglycemia Alarm and Narrower Threshold Range for Hyper/Hypoglycemia Alarm on Continuous Glucose Monitoring Systems Correlate with Lower Average Glucose Levels and Longer Time-in-Range

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 979-P
Author(s):  
YU KUEI LIN ◽  
MAN HUNG ◽  
ANU SHARMA ◽  
OWEN CHAN ◽  
MICHAEL VARNER ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Monitoring Systems ◽  
Glucose Levels ◽  
Lower Glucose ◽  
Time In Range ◽  
Average Glucose ◽  
Threshold Range

scholarly journals Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study

2019 ◽  
Vol 104 (10) ◽  
pp. 4356-4364 ◽  
Author(s):  
Viral N Shah ◽  
Stephanie N DuBose ◽  
Zoey Li ◽  
Roy W Beck ◽  
Anne L Peters ◽  
...  
Keyword(s):  
Prospective Study ◽  
Median Time ◽  
Continuous Glucose Monitoring ◽  
Age Groups ◽  
Glucose Monitoring ◽  
Future Research ◽  
Glucose Levels ◽  
Sensor Glucose ◽  
Multicenter Prospective Study ◽  
Average Glucose

Abstract Context Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation CGM devices is lacking. Objective To establish reference sensor glucose ranges in healthy, nondiabetic individuals across different age groups using a current generation CGM sensor. Design Multicenter, prospective study. Setting Twelve centers within the T1D Exchange Clinic Network. Patients or Participants Nonpregnant, healthy, nondiabetic children and adults (age ≥6 years) with nonobese body mass index. Intervention Each participant wore a blinded Dexcom G6 CGM, with once-daily calibration, for up to 10 days. Main Outcome Measures CGM metrics of mean glucose, hyperglycemia, hypoglycemia, and glycemic variability. Results A total of 153 participants (age 7 to 80 years) were included in the analyses. Mean average glucose was 98 to 99 mg/dL (5.4 to 5.5 mmol/L) for all age groups except those over 60 years, in whom mean average glucose was 104 mg/dL (5.8 mmol/L). The median time between 70 to 140 mg/dL (3.9 to 7.8 mmol/L) was 96% (interquartile range, 93 to 98). Mean within-individual coefficient of variation was 17 ± 3%. Median time spent with glucose levels >140 mg/dL was 2.1% (30 min/d), and median time spent with glucose levels <70 mg/dL (3.9 mmol/L) was 1.1% (15 min/d). Conclusion By assessing across age groups in a healthy, nondiabetic population, normative sensor glucose data have been derived and will be useful as a benchmark for future research studies.

scholarly journals Outcome of Patients with ST-T Changes in Non STSegment Elevation Myocardial Infarction

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Mohammad Arifur Rahman
Keyword(s):  
Myocardial Infarction ◽  
Continuous Glucose Monitoring ◽  
Hemoglobin A1c ◽  
Glycated Hemoglobin ◽  
Glucose Monitoring ◽  
Measurement Methods ◽  
Glucose Levels ◽  
Sensor Device ◽  
Sensor Glucose ◽  
Average Glucose

This article discusses the fundamental characteristics of measured glucose levels and predicted glycated hemoglobin A1c (HbA1c) values among three sets of collected data, measured finger-piercing and continuous glucose monitoring (CGM) sensor device collected glucose levels at 15-minute (15-min) and 5-minute (5-min) intervals. The average glucose (in milligram per deciliter-mg/dL) is listed below: Finger glucose: 109 mg/dL (100%) Sensor at 15-min: 120 mg/dL (109%) Sensor at 5-min: 117 mg/dL (107%) Using candlestick chart, the comparison of average glucoses during this period between two sensor glucose (mg/dL) data (15-min/5-min) are as follows: Open glucose: 108/111 Close glucose: 115/115 Maximum (max) glucose: 170 /175 Minimum (min) glucose: 85/83 Average glucose: 120/117 Additional analysis of time above range (TAR)≥140 mg/dL for hyperglycemia, time within the range (TIR) from 70-140 mg/dL for normal, time below range (TBR)≤70 mg/dL for hypoglycemia based on two sensor candlesticks revealing the following information in a specific format of TAR%/ TIR%/TBR%. 15-min:18.3%, 80.5%, 1.2% 5-min: 17.0%, 81.9%, 1.1% By evaluating the results of the TIR analysis, the 5-min glucose levels appear to be marginally healthier (1.4%) than the 15-min ones. During the coronavirus pandemic (COVID 19) quarantine period, the author lived a rather unique lifestyle which is extremely calm with regular routines, such as eating home-cooked meals and exercising on a regular basis. As a result, his HbA1c has decreased from 6.6% to 6.3% with an average A1c of 6.4% without taking any diabetes medications. However, these three different measurement methods still provide three different sets of glucoses levels which are within a 10% margin of differences, while the HbA1c values are particularly close to each other between the finger-piercing and CGM 15-min.

The utility of continuous glucose monitoring systems in the management of children with persistent hypoglycaemia

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sathyakala Vijayanand ◽  
Paul G. Stevenson ◽  
Maree Grant ◽  
Catherine S. Choong ◽  
Elizabeth A. Davis ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Congenital Hyperinsulinism ◽  
Glucose Levels ◽  
Parent Experience ◽  
Lower Glucose ◽  
Sensor Glucose ◽  
The Mean ◽  
Improved Accuracy

Abstract Objectives Glucose monitoring is vital in children with persistent hypoglycaemia to reduce the risk of adverse neuro-behavioural outcomes; especially in children with hyperinsulinism. The role of continuous glucose monitoring (CGM) systems in monitoring glucose levels in this cohort is limited. The objective of this study was to ascertain the effectiveness of CGM and to evaluate parents’ experience of using CGM for monitoring glucose levels in children with hypoglycaemia. Methods Retrospective analysis of sensor glucose (SG) values from Dexcom G4 CGM with paired finger-prick blood glucose (BG) values was performed to determine the accuracy of CGM. The parent experience of CGM was assessed using a questionnaire administered to families of children with congenital hyperinsulinism currently attending the clinic. Results SG data from 40 children (median age 6 months) with persistent hypoglycaemia (60% Hyperinsulinism) were analysed. The mean difference between 5,650 paired BG and SG values was 0.28 mmol/L. The sensitivity and specificity of CGM to identify severe hypoglycaemia (BG < 3.0 mmol/L) were 54.3% (95% CI: 39.0%, 69.1%) and 97.4% (95% CI: 96.9%, 97.8%) respectively. Parents (n=11) reported less anxiety (n=9), better sleep at night (n=7) and preferred to use CGM for monitoring (n=9). Conclusions Although the high number of false-positive readings precludes the routine use of CGM in the evaluation of hypoglycaemia, it avoids unnecessary BG testing during normoglycaemia. It is an acceptable tool for parents for monitoring their children who are at risk of hypoglycaemia. Newer CGM systems with improved accuracy at lower glucose levels have the potential to further improve monitoring.

scholarly journals Interstitium versus Blood Equilibrium in Glucose Concentration and its Impact on Subcutaneous Continuous Glucose Monitoring Systems

2010 ◽  
Vol 10 (1) ◽  
pp. 36 ◽  
Author(s):  
Cosimo Scuffi ◽  
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Glucose Concentration ◽  
Interstitial Fluid ◽  
Glucose Monitoring ◽  
Foreign Body Response ◽  
Monitoring Systems ◽  
Glucose Levels ◽  
Consequent Reduction ◽  
The Impact

The relationship between both interstitial and blood glucose remains a debated topic, on which there is still no consensus. The experimental evidence suggests that blood and interstitial fluid glucose levels are correlated by a kinetic equilibrium, which as a consequence has a time and magnitude gradient in glucose concentration between blood and interstitium. Furthermore, this equilibrium can be perturbed by several physiological effects (such as foreign body response, wound-healing effect, etc.), with a consequent reduction of interstitial fluid glucose versus blood glucose correlation. In the present study, the impact of operating in the interstitium on continuous glucose monitoring systems (CGMs) will be discussed in depth, both for the application of CGMs in the management of diabetes and in other critical areas, such as tight glycaemic control in critically ill patients.

scholarly journals Application of Continuous Glucose Monitoring for Assessment of Individual Carbohydrate Requirement during Ultramarathon Race

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1121
Author(s):  
Kengo Ishihara ◽  
Natsuki Uchiyama ◽  
Shino Kizaki ◽  
Emi Mori ◽  
Tsutomu Nonaka ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Concentration ◽  
Glucose Monitoring ◽  
Carbohydrate Intake ◽  
Running Speed ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Food And Drink ◽  
Average Glucose Concentration ◽  
Average Glucose

Background: The current study intended to evaluate the feasibility of the application of continuous glucose monitoring to guarantee optimal intake of carbohydrate to maintain blood glucose levels during a 160-km ultramarathon race. Methods: Seven ultramarathon runners (four male and three female) took part in the study. The glucose profile was monitored continuously throughout the race, which was divided into 11 segments by timing gates. Running speed in each segment was standardized to the average of the top five finishers for each gender. Food and drink intake during the race were recorded and carbohydrate and energy intake were calculated. Results: Observed glucose levels ranged between 61.9–252.0 mg/dL. Average glucose concentration differed from the start to the end of the race (104 ± 15.0 to 164 ± 30.5 SD mg/dL). The total amount of carbohydrate intake during the race ranged from 0.27 to 1.14 g/kg/h. Glucose concentration positively correlated with running speeds in segments (P < 0.005). Energy and carbohydrate intake positively correlated with overall running speed (P < 0.01). Conclusion: The present study demonstrates that continuous glucose monitoring could be practical to guarantee optimal carbohydrate intake for each ultramarathon runner.

scholarly journals Comparison of Glucose and HBA1C Values Between Finger-Piercing and Continuous Glucose Monitoring Sensor Using Gh-Method: Math-Physical Medicine (no. 293)

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Gerald C Hsu
Keyword(s):  
Continuous Glucose Monitoring ◽  
Hemoglobin A1c ◽  
Glycated Hemoglobin ◽  
Glucose Monitoring ◽  
Measurement Methods ◽  
Physical Medicine ◽  
Glucose Levels ◽  
Sensor Device ◽  
Sensor Glucose ◽  
Average Glucose

This article discusses the fundamental characteristics of measured glucose levels and predicted glycated hemoglobin A1c (HbA1c) values among three sets of collected data, measured finger-piercing and continuous glucose monitoring (CGM) sensor device collected glucose levels at 15-minute (15-min) and 5-minute (5-min) intervals. The average glucose (in milligram per deciliter-mg/dL) is listed below: Finger glucose: 109 mg/dL (100%) Sensor at 15-min: 120 mg/dL (109%) Sensor at 5-min: 117 mg/dL (107%) Using candlestick chart, the comparison of average glucoses during this period between two sensor glucose (mg/dL) data (15-min/5-min) are as follows: Open glucose: 108/111 Close glucose: 115/115 Maximum (max) glucose: 170 /175 Minimum (min) glucose: 85/83 Average glucose: 120/117 Additional analysis of time above range (TAR)≥140 mg/dL for hyperglycemia, time within the range (TIR) from 70-140 mg/dL for normal, time below range (TBR)≤70 mg/dL for hypoglycemia based on two sensor candlesticks revealing the following information in a specific format of TAR%/ TIR%/TBR%. 15-min:18.3%, 80.5%, 1.2% 5-min: 17.0%, 81.9%, 1.1% By evaluating the results of the TIR analysis, the 5-min glucose levels appear to be marginally healthier (1.4%) than the 15-min ones. During the coronavirus pandemic (COVID 19) quarantine period, the author lived a rather unique lifestyle which is extremely calm with regular routines, such as eating home-cooked meals and exercising on a regular basis. As a result, his HbA1c has decreased from 6.6% to 6.3% with an average A1c of 6.4% without taking any diabetes medications. However, these three different measurement methods still provide three different sets of glucoses levels which are within a 10% margin of differences, while the HbA1c values are particularly close to each other between the finger-piercing and CGM 15-min.

scholarly journals Thresholds of Glycemia and the Outcomes of COVID-19 Complicated With Diabetes: A Retrospective Exploratory Study Using Continuous Glucose Monitoring

2021 ◽  
Author(s):  
Yun Shen ◽  
Xiaohong Fan ◽  
Lei Zhang ◽  
Yaxin Wang ◽  
Cheng Li ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Adverse Outcomes ◽  
Glucose Levels ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Sensor Glucose ◽  
Elevated Glucose ◽  
Time In Range ◽  
Design And Methods

<i>Objective: </i>Although elevated glucose levels are reported to be associated with adverse outcomes of coronavirus disease 2019 (COVID-19), the optimal range of glucose in patients with COVID-19 and diabetes remains unknown. This study aimed to investigate the threshold of glycemia and its association with the outcomes of COVID-19. <p><i>Research design and methods:</i> Glucose levels were assessed via intermittently scanned continuous glucose monitoring in 35 patients with an average period of 10.2 days. The percentages of time above range (TAR), time below range (TBR), time in range (TIR), and coefficient of variation (CV) were calculated. Composite adverse outcomes were defined as either the need for admission to intensive care unit, need for mechanic ventilation, or morbidity with critical illness. </p> <p><i>Results:</i> TARs with the threshold from 160 mg/dL - 200 mg/dL were all significantly associated with composite adverse outcomes after adjustment of covariates. Both TBR (<70 mg/dL) and TIR of 70 mg/dL - 160 mg/dL, but not mean sensor glucose level, were significantly associated with composite adverse outcomes and prolonged hospitalization. The multivariate-adjusted odds ratios of the CV of sensor glucose across its tertiles for composite adverse outcomes of COVID-19 were 1.00, 1.18, and 25.2, respectively. </p> <p><i>Conclusions:</i> Patients with diabetes and COVID-19 have an increased risk of adverse outcomes with glucose levels over 160 mg/dL, below 70 mg/dL, and a high CV. Therapies that improve these metrics of glycemic control may result in better prognoses for these patients.</p>

scholarly journals Thresholds of Glycemia and the Outcomes of COVID-19 Complicated With Diabetes: A Retrospective Exploratory Study Using Continuous Glucose Monitoring

2021 ◽  
Author(s):  
Yun Shen ◽  
Xiaohong Fan ◽  
Lei Zhang ◽  
Yaxin Wang ◽  
Cheng Li ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Adverse Outcomes ◽  
Glucose Levels ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Sensor Glucose ◽  
Elevated Glucose ◽  
Time In Range ◽  
Design And Methods

<i>Objective: </i>Although elevated glucose levels are reported to be associated with adverse outcomes of coronavirus disease 2019 (COVID-19), the optimal range of glucose in patients with COVID-19 and diabetes remains unknown. This study aimed to investigate the threshold of glycemia and its association with the outcomes of COVID-19. <p><i>Research design and methods:</i> Glucose levels were assessed via intermittently scanned continuous glucose monitoring in 35 patients with an average period of 10.2 days. The percentages of time above range (TAR), time below range (TBR), time in range (TIR), and coefficient of variation (CV) were calculated. Composite adverse outcomes were defined as either the need for admission to intensive care unit, need for mechanic ventilation, or morbidity with critical illness. </p> <p><i>Results:</i> TARs with the threshold from 160 mg/dL - 200 mg/dL were all significantly associated with composite adverse outcomes after adjustment of covariates. Both TBR (<70 mg/dL) and TIR of 70 mg/dL - 160 mg/dL, but not mean sensor glucose level, were significantly associated with composite adverse outcomes and prolonged hospitalization. The multivariate-adjusted odds ratios of the CV of sensor glucose across its tertiles for composite adverse outcomes of COVID-19 were 1.00, 1.18, and 25.2, respectively. </p> <p><i>Conclusions:</i> Patients with diabetes and COVID-19 have an increased risk of adverse outcomes with glucose levels over 160 mg/dL, below 70 mg/dL, and a high CV. Therapies that improve these metrics of glycemic control may result in better prognoses for these patients.</p>

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