scholarly journals Continuous Glucose Monitoring System Versus Self-Monitoring Blood Glucose in Type 1 Diabetes Mellitus Children: A Randomised Controlled Trial (RoSEC)

2021 ◽  
Vol 27 (2) ◽  
pp. 51-68
Author(s):  
Muhd Alwi Muhd Helmi ◽  
Norsa'adah Bachok ◽  
Suhaimi Hussain
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Controlled Trial ◽  
Glucose Monitoring ◽  
Control Group ◽  
Self Monitoring ◽  
The Mean

Objectives: The primary and secondary objectives were to compare the glycaemic control and frequency of hypoglycaemia between continuous glucose monitoring system (CGMS) and self-monitoring blood glucose (SMBG). Methods: A single centre, randomised, parallel-group controlled trial was conducted involving twenty-two type one Diabetes Mellitus (T1DM) patients with the mean age of 13.8 years assigned to either intervention or control group. All respondents wore the CGMS device at the beginning of the study. Intervention group (n=11) had their insulin adjusted based on the CGMS data, while the control group (n=11) was based on SMBG. Monthly average blood sugar level (BSL) and monthly mean hypoglycemic events per week (HE/wk) were measured at baseline, first month, second month, and third month. HbA1c levels were measured at baseline and in the third month. Results: The baseline characteristics were similar. The data were analysed using repeated measure analysis of variance (ANOVA). The mean difference of HbA1c within the group was not statistically significant with p=0.322. There were significant differences in the monthly mean HE/wk within and between groups, p=0.004, and p=0.037. Conclusion: In conclusion, CGMS is equivalent to SMBG in optimising glycaemic control but is more effective in detecting hypoglycaemia in children.  

scholarly journals Continuous Glucose Monitoring for the Detection of Hypoglycemia in Patients With Diabetes of the Exocrine Pancreas

2020 ◽  
pp. 193229682097474
Author(s):  
Channabasappa Shivaprasad ◽  
Kolla Gautham ◽  
Kejal Shah ◽  
Soumya Gupta ◽  
Preethika Palani ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Exocrine Pancreas ◽  
Glucose Monitoring ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Patients With Diabetes ◽  
The Mean ◽  
Mean Time

Background: Detailed evaluations of hypoglycemia and associated indices based on continuous glucose monitoring (CGM) are limited in patients with diabetes of the exocrine pancreas. Our study sought to evaluate the frequency and pattern of hypoglycemic events and to investigate hypoglycemia-specific indices in this population. Methods: This was a cross-sectional study comprising 83 participants with diabetes of the exocrine pancreas. CGM and self-monitoring of blood glucose (SMBG) were performed on all participants for a minimum period of 72 hours. The frequency and pattern of hypoglycemic events, as well as hypoglycemia-related indices, were evaluated. Results: Hypoglycemia was detected in 90.4% of patients using CGM and 38.5% of patients using SMBG. Nocturnal hypoglycemic events were more frequent (1.9 episodes/patient) and prolonged (142 minutes) compared with day-time events (1.1 episodes/patient; 82.8 minutes, P < 0.05). The mean low blood glucose index was 2.1, and glycemic risk assessment diabetes equation hypoglycemia was 9.1%. The mean time spent below (TSB) <70 mg/dL was 9.2%, and TSB <54 mg/dL was 3.7%. The mean area under curve (AUC) <70 mg/dL was 1.7 ± 2.5 mg/dL/hour and AUC <54 mg/dL was 0.6 ± 1.3 mg/dL/hour. All of the CGM-derived hypoglycemic indices were significantly more deranged at night compared with during the day ( P < 0.05). Conclusion: Patients with diabetes of the exocrine pancreas have a high frequency of hypoglycemic episodes that are predominantly nocturnal. CGM is superior to SMBG in the detection of nocturnal and asymptomatic hypoglycemic episodes. CGM-derived hypoglycemic indices are beneficial in estimating the risk of hypoglycemia.

scholarly journals Effects of intermittently scanned continuous glucose monitoring on blood glucose control and the production of urinary ketone bodies in pregestational diabetes mellitus

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Shu-ying Li ◽  
Hang Guo ◽  
Yi Zhang ◽  
Pei Li ◽  
Pei Zhou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Sugar ◽  
Continuous Glucose Monitoring ◽  
Glucose Control ◽  
Ketone Bodies ◽  
Blood Glucose Control ◽  
Glucose Monitoring ◽  
Control Group ◽  
Pregestational Diabetes

Abstract Objective To investigate the effects of intermittently scanned continuous glucose monitoring (isCGM) on blood glucose control, clinical value of blood glucose monitoring and production of urinary ketone bodies in pregestational diabetes mellitus. Method A total of 124 patients with pregestational diabetes mellitus at 12–14 weeks of gestation admitted to the gestational diabetes clinic of our hospital from December 2016 to December 2018 were selected and randomly divided into two groups. Sixty patients adopted self-monitoring of blood glucose (SMBG) were taken as the control group, and the other 64 patients adopted isCGM system by wearing the device for 14 days. Blood sugar control, glycosylated albumin level, ketone production in urine, the maximum and minimum of blood sugar value measured by different monitoring methods and their occurrence time were observed in the two groups. Result (1) No statistically significant differences were found between the groups in terms of maternal age, gestational age at first visit, family history, duration of diabetes, education level, total insulin dose, chronic hypertension, abortion history, nulliparity, assisted reproductive technology, history of macrosomia childbirth, pre-pregnancy BMI, and overweight (%) at the first visit and hypoglycemia, (2) the value of Glycated Albumin was lower in the CGM group compared to the control group at 2ed weeks (14.6 ± 2.2 vs. 16.8 ± 2.7, p < 0.001). The women in the CGM group spent increased time in the recommended glucose control target range of 3.5–7.8 mmol/L (69 ± 10% vs. 62 ± 11%, p < 0.001) and reduced time above target compared with those in the control group at 2 weeks (25 ± 7% vs. 31 ± 8%, p < 0.001). In the second week of the study, the positive rate of urinary ketone body in isCGM group was lower than that in the control group (42 ± 5 vs. 54 ± 5, p < 0.001), and (3) the minimum blood glucose of 31.2% (20/64) cases in isCGM group appeared during 0:00–2:59 at night, and 26.6% (17/64) cases appeared during 3:00–5:59 at night. The minimum values of 40.0% (24/60) cases in the control group appeared within the 30 min before lunch, 23.3% (14/60) within the 30 min before breakfast, and 11.7% (7/60) within the 30 min before dinner. The cases of minimum of blood sugar before meals accounted for 75% of all the minimum values, and the cases of minimum at night only accounted for 8.3%. Conclusion Intermittently scanned continuous glucose monitoring can reduce hyperglycemia exposure and ketone body formation in pregestational diabetes mellitus. In addition, isCGM is better than SMBG in detecting nocturnal hypoglycemia.

scholarly journals A comparison of FreeStyle Libre 2 to self-monitoring of blood glucose in children with type 1 diabetes and sub-optimal glycaemic control: a 12-week randomised controlled trial protocol

2021 ◽  
Author(s):  
Sara Styles ◽  
Ben Wheeler ◽  
Alisa Boucsein ◽  
Hamish Crocket ◽  
Michel de Lange ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Second Generation ◽  
Controlled Trial ◽  
Glucose Monitoring ◽  
Self Monitoring ◽  
Freestyle Libre ◽  
Randomised Controlled

Abstract Purpose Frequent glucose monitoring is necessary for optimal glycaemic control. Second-generation intermittently scanned glucose monitoring (isCGM) systems inform users of out-of-target glucose levels and may reduce monitoring burden. We aim to compare FreeStyle Libre 2 (Abbott Diabetes Care, Witney, U.K.) to self-monitoring of blood glucose in children with type 1 diabetes and sub-optimal glycaemic control. Methods This open-label randomised controlled trial will enrol 100 children (4–13 years inclusive, diagnosis of type 1 diabetes ≥ 6 months, HbA1c 58–110 mmol/mol [7.5–12.2%]), from 5 New Zealand diabetes centres. Following 2 weeks of blinded sensor wear, children will be randomised 1:1 to control or intervention arms. The intervention (duration 12 weeks) includes second-generation isCGM (FreeStyle Libre 2) and education on using interstitial glucose data to manage diabetes. The control group will continue self-monitoring blood glucose. The primary outcome is the difference in glycaemic control (measured as HbA1c) between groups at 12 weeks. Pre-specified secondary outcomes include change in glucose monitoring frequency, glycaemic control metrics and psychosocial outcomes at 12 weeks as well as isCGM acceptability. Discussion This research will investigate the effectiveness of the second-generation isCGM to promote recommended glycaemic control. The results of this trial may have important implications for including this new technology in the management of children with type 1 diabetes. Trial registration This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry on 19 February 2020 (ACTRN12620000190909p) and the World Health Organization International Clinical Trials Registry Platform (Universal Trial Number U1111-1237-0090).

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