scholarly journals The Use of Continuous Glucose Monitoring System in Combination with Individualized Lifestyle and Therapeutic Recommandations on Glycemic Control of Type 2 Diabetes Patients

2014 ◽  
Vol 21 (4) ◽  
pp. 291-299
Author(s):  
Anca-Elena Crăciun ◽  
Cornelia Bala ◽  
Cristian Crăciun ◽  
Gabriela Roman ◽  
Carmen Georgescu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Body Fat ◽  
Visceral Fat ◽  
Glucose Monitoring ◽  
Visceral Fat Area

Abstract Background and aims. The aim of our research was to evaluate the impact of short-time continuous glucose monitoring (CGM) on glycemic control evaluated by HbA1c and within-day glucose variability. We also assessed if the initiation of insulin therapy in conjunction with lifestyle recommendations may prevent the weight gain. Materials and method. We included 28 patients with type 2 diabetes with 2 consecutive CGMS recordings available (baseline and follow-up) and for which were collected data on weight, body mass index (BMI), percentage (%) of body fat, visceral fat area, HbA1c and glycemic variability. Results. The HbA1c decreased significantly from 8.8% at baseline to 7.3% at follow-up (p <0.0001) in the whole group, and from 10.5% to 7.5% in the subgroup for which the insulin therapy was initiated at baseline (p=0.011). The BMI, % body fat and visceral fat area decreased significantly from 29.2 kg/m2 to 28.4 kg/m2; from 32.3% to 30.4%; and from 141.6 to 129.3 (cm2), respectively. No increase of these parameters was observed in the subgroup for which the insulin therapy was initiated at baseline. Conclusion. The use of CGMS in combination with individualized lifestyle and therapeutic recommendations may have a beneficial effect on glycemic control and may prevent the weight gain associated with insulin initiation.

scholarly journals Flash CGM Is Associated With Reduced Diabetes Events and Hospitalizations in Insulin-Treated Type 2 Diabetes

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Richard M Bergenstal ◽  
Matthew S D Kerr ◽  
Gregory J Roberts ◽  
Diana Souto ◽  
Yelena Nabutovsky ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Emergency Services ◽  
Glucose Monitoring ◽  
Emergency Department Utilization ◽  
Acting Insulin ◽  
Acute Diabetes ◽  
The Impact

Abstract Purpose Suboptimal glycemic control among individuals with diabetes is a leading cause of hospitalizations and emergency department utilization. Use of flash continuous glucose monitoring (flash CGM) improves glycemic control in type 1 and type 2 diabetes, which may result in lower risk for acute and chronic complications that require emergency services and/or hospitalizations. Methods In this retrospective, real-world study, we analyzed IBM MarketScan Commercial Claims and Medicare Supplemental databases to assess the impact of flash CGM on diabetes-related events and hospitalizations in a cohort of 2463 individuals with type 2 diabetes who were on short- or rapid-acting insulin therapy. Outcomes were changes in acute diabetes-related events (ADE) and all-cause inpatient hospitalizations (ACH), occurring during the first 6 months after acquiring the flash CGM system compared with event rates during the 6 months prior to system acquisition. ICD-10 codes were used to identify ADE for hypoglycemia, hypoglycemic coma, hyperglycemia, diabetic ketoacidosis, and hyperosmolarity. Results ADE rates decreased from 0.180 to 0.072 events/patient-year (hazard ratio [HR]: 0.39 [0.30, 0.51]; P &lt; 0.001) and ACH rates decreased from 0.420 to 0.283 events/patient-year (HR: 0.68 [0.59 0.78]; P &lt; 0.001). ADE reduction occurred regardless of age or gender. Conclusions Acquisition of the flash CGM system was associated with reductions in ADE and ACH. These findings provide support for the use of flash CGM in type 2 diabetes patients treated with short- or rapid-acting insulin therapy to improve clinical outcomes and potentially reduce costs.

scholarly journals Long Term Evaluation of Intensive Insulin Therapy in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 2 (3) ◽  
pp. 88-94
Author(s):  
Leilani B Mercado-Asis ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Demographic Data

Background: This study aimed to determine long-term effect of intensive insulin therapy on prevention, progression, and development of chronic diabetes complications, both micro and macrovascular events. This study also aimed to evaluate long-term sustainability of glycemic control of patients on intensive insulin treatment. Methods: A retrospective review of adult type 2 diabetes mellitus (T2DM) patients on intensive insulin therapy for ≥7 years. Demographic data, co-morbidities, body mass index (BMI), hemoglobin A1c (HbA1c), hospitalization were collated. Majority received intensive insulin therapy with combination of premixed 70/30 given two times a day and fast short acting analogue given premeal three times a day, with the addition of glargine or degludec once a day in some. Results: Among 76 patients, 62% were males and 38% were females. Mean age at diagnosis and last visit were 53 and 65 years, respectively. At time of diagnosis, patient had the following co-morbidities: hypertension (32%), dyslipidemia (13%), non-dialyzable chronic kidney disease (CKD) (4%), thyroid disease (1%), pulmonary tuberculosis (1%). In terms of long-term complications, event rates during follow up period are as follows: 0.001 per person-year for acute coronary event; 0.002 per person-year for CKD needing dialysis, 0.009 per person-year for cerebrovascular accident. There were no blindness and amputation observed. There is a statistical difference between HbA1c levels at time of diagnosis (8.53 ± 1.86) and last follow up (7.83 ± 1.71) (P = 0.00). After a median follow up of 12 years (7–22 years), glycemic control was sustained with an HbA1c of ≤7% and ≤8% in 32% and 45% of patients, respectively. Conclusion: With intensive insulin therapy, micro and macrovascular complications can be prevented significantly. Long-term sustainability of glycemic control was also achieved.

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