906-P: The Association of British Clinical Diabetologists Audit of Freestyle Libre (FSL) in Diabetes in United Kingdom: Determinants of Time-in-Target Range

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 906-P
Author(s):  
EMMA G. WILMOT ◽  
HARSHAL DESHMUKH ◽  
JANE PATMORE ◽  
THOZHUKAT SATHYAPALAN ◽  
CHRISTOPHER WALTON ◽  
...  
2020 ◽  
Vol 6 ◽  
pp. 205520762097034
Author(s):  
Nicole Kim ◽  
Kevin Pham ◽  
Allen Shek ◽  
Jeremy Lim ◽  
Xiaohan Liu ◽  
...  

Background Continuous glucose monitoring (CGM) measures interstitial glucose levels through a sensor with a thin filament inserted under the skin. It is customary for patients to rotate sensor application sites between arms to minimize skin irritation. However, there is limited data regarding the degree of inter-arm differences with CGM technology. Methods Self-proclaimed right-handed (n = 5) and left-handed (n = 5) participants, regardless of concurrent comorbidities, were enrolled for CGM. Participants wore a FreeStyle Libre Pro sensor on each arm for a maximum of 14 days. Muscle mass and body fat analysis was conducted using a multi-frequency segmental body composition analyzer. Glucose levels from both arms were time-matched with the first 12 hours eliminated from analysis. Mean glucose and time in target range were compared between readings from the right and left arm. Results A total of 9830 paired glucose levels were included for analysis. In all participants (n = 10), mean glucose on the right arm was 89.1 mg/dL (SD, 19.9) and 85.3 mg/dL (SD, 19.3) on the left arm (P < 0.001). Glucose was out of target range (70-180 mg/dL) for 12.7% of the time in the right arm compared to 18.5% in the left arm (P < 0.001). Conclusions In a group of 10 nondiabetic and diabetic adults, there was a statistically significant difference in CGM readings between the right and left arms. Time in target range may differ based on arm selection when using a CGM. Arm dominance did not explain the inter-arm glucose level discordance.


2020 ◽  
Vol 169 ◽  
pp. 108451
Author(s):  
Jason I. Chiang ◽  
Jo-Anne Manski-Nankervis ◽  
Sharmala Thuraisingam ◽  
Alicia Jenkins ◽  
David O'Neal ◽  
...  

2022 ◽  
Vol 8 (4) ◽  
pp. 267-269
Author(s):  
Abhijit Trailokya ◽  
Suhas Erande ◽  
Amol Aiwale

This study aimed to assess effectiveness of Evogliptin 5 mg through continues glucose monitoring (CGM) in patients with T2DM in retrospective observational real world settings. Overall 6 patients who received Evogliptin as routine clinical practice in management of T2DM were analyzed retrospectively from single center. Data collected from past medical records. FreeStyle Librepro 1.0.6 was used for CGM. CGM was done 15 days prior to adding Evogliptin and repeated immediately after that for next 15 days. Mean BG level, Percentage time in target range (80-140mg/dl), Percentage time above target and Percentage time below target were assessed prior and after adding Evogliptin in existing treatment regimen. Significant reduction in Mean blood glucose level seen after adding Evogliptin in existing treatment regimen from 215 mg/dl to 138 mg/dl (-77 mg/dl P=0.006). Significant improvement seen in Percentage time in target range (80-140mg/dl) from 17% to 44% (27% P value 0.007) and in Percentage time above target from 81% to 43% (- 38%, P valve 0.003). 13.5 % of the patients seen below target. Evogliptin was found to be effective when added to the patients who were uncontrolled on other oral anti-diabetic medications. It effectively showed improvement in continues glucose monitoring (CGM) parameters like Mean blood glucose, more number of patients were in Time in Target range i.e (80-140mg/dl) after adding Evogliptin to existing anti-diabetic medications & well tolerated. Small sample size and retrospective study


2020 ◽  
Vol 17 (5) ◽  
pp. 147916412095861
Author(s):  
Rumyana Dimova ◽  
Nevena Chakarova ◽  
Greta Grozeva ◽  
Tsvetalina Tankova

Aims: The present study aims to investigate the relationship between cardiac autonomic function (CAF) and glucose variability (GV) and HOMA-IR in subjects with prediabetes and normal glucose tolerance (NGT). Material and methods: Ninety-two subjects (59 with prediabetes and 33 with NGT), of mean age 50.3 ± 11.5 years, mean BMI 30.4 ± 6.0 kg/m2, were included in this cross-sectional study. Glucose tolerance was assessed by OGTT according to WHO 2006 criteria. Glucose, HbA1c, insulin, oxLDL, and 3-Nitrotyrosine were measured. CGM was performed with a blinded sensor (FreeStyle Libre Pro). CAF was assessed by ANX-3.0 technology. Results: GV indices were increased in prediabetes. CAF was suppressed in subjects with any stage of dysglycemia. The prevalence of cardiac autonomic dysfunction was higher in prediabetes −20.3% as compared to NGT −3.0%, p = 0.028. HOMA-IR [OR 1.5 (95% CI: 1.1–2.1), p = 0.010] and time in target range [OR 0.8 (95% CI: 0.67–0.97), p = 0.021] were found to be predictive variables for impaired CAF. Sympathetic and parasympathetic activity negatively correlated with mean glycemia and GV indices and were independently related to JINDEX in prediabetes ( F[1, 47] = 5.76, p = 0.021 and F[1, 47] = 5.94, p = 0.019, respectively); and to time above target range in NGT ( F[1, 18] = 4.48, p = 0.049 and F[1, 18] = 4.65, p = 0.046, respectively). Conclusion: CAF is declined in prediabetes and seems to be related to GV and HOMA-IR at early stages of dysglycemia.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 959-P ◽  
Author(s):  
EMMA G. WILMOT ◽  
HARSHAL DESHMUKH ◽  
DAVID BISHOP ◽  
DAVID W. LIPSCOMB ◽  
RUMAISA BANATWALLA ◽  
...  

2021 ◽  
pp. 193229682098510
Author(s):  
Chinenye O. Usoh ◽  
Crystal Paige Johnson ◽  
Jaime L. Speiser ◽  
Richa Bundy ◽  
Ajay Dharod ◽  
...  

Background: Hybrid closed-loop (HCL) insulin pump therapy (Medtronic 670G) is an emerging technology that is growing in use worldwide. Initial clinical trials demonstrated the effectiveness of HCL in reducing hypoglycemia and improving glucose control; however, these subjects were intensely monitored and supervised. There has been concern regarding the ability of patients to remain in auto mode. We aimed to assess HCL when used in a typical outpatient endocrine clinic. Methods: We initially analyzed data from 80 individuals with type 1 diabetes managed in an endocrine clinic by a single certified diabetes educator (CDE). We then included our other providers and had 230 subjects by the end of the study. Patients were either transitioned from traditional insulin pump or multiple daily insulin injection therapy (MDI) to HCL. Patients initiated to HCL pump therapy from July 2017 through February 2020 were studied. Endpoints of change in time in hypoglycemic/hyperglycemic range and time in target range were analyzed. The primary outcome was a change in percent time in the target range during manual mode compared with auto mode. Results: There was an 18.2% increase in average time in target range when comparing manual mode to auto mode (59.3% vs 70.1%, P < .0001). Average time in hyperglycemic range was significantly reduced by 26.7% (39.0% vs 28.6%, P < .0001) but without increasing average time in hypoglycemic range (1.7% vs 1.3%, P = 0.95). Conclusions: HCL was effective in reducing hyperglycemia and increasing time in the target range but did not increase hypoglycemia. These data suggest HCL will improve the metrics of glucose control.


Author(s):  
Dave L. Dixon ◽  
William L. Baker ◽  
Leo F. Buckley ◽  
Teresa M. Salgado ◽  
Benjamin W. Van Tassell ◽  
...  

Longer time in target range (TTR) for systolic blood pressure (SBP) is associated with a lower risk of cardiovascular events. Team-based care improves SBP control but its effect on the consistency of SBP control over time is unknown. This post hoc analysis used data from a cluster-randomized trial of a physician/pharmacist collaborative model that randomized medical offices to either a 9- or 24-month pharmacist intervention or control group. TTR for SBP was calculated using linear interpolation and an SBP range of 110 to 130 mm Hg. TTR is reported as median values and group comparisons assessed using the Kruskal-Wallis test. Of the 625 participants enrolled, 524 had 9-month and 366 had 24-month SBP data. Participants were a median 59 years old, 59% female, and 52% minority. After 24 months, the median TTR for SBP was 31.9% and 29.8% for the 9- and 24-month intervention groups, respectively, compared with 19% in the control group ( P =0.0068). This observation persisted in the subgroup of participants with diabetes or chronic kidney disease and minorities. A longer TTR was not associated with an increased risk of adverse drug events. Time to first observed SBP in the target range was shorter in the intervention group compared with control (270 versus 365 days; P =0.0047). A physician/pharmacist collaborative care model achieved longer TTR for SBP compared with control (usual care).


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