Nocturnal Continuous Glucose Monitoring: Accuracy and Reliability of Hypoglycemia Detection in Patients with Type 1 Diabetes at High Risk of Severe Hypoglycemia

2013 ◽  
Vol 15 (5) ◽  
pp. 371-377 ◽  
Author(s):  
Christiane Bay ◽  
Peter Lommer Kristensen ◽  
Ulrik Pedersen-Bjergaard ◽  
Lise Tarnow ◽  
Birger Thorsteinsson
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Monitoring Accuracy

scholarly journals Glycemic Variability and Hypoglycemic Excursions With Continuous Glucose Monitoring Compared to Intermittently Scanned Continuous Glucose Monitoring in Adults With Highest Risk Type 1 Diabetes

2019 ◽  
Vol 14 (3) ◽  
pp. 567-574 ◽  
Author(s):  
Parizad Avari ◽  
Vanessa Moscardo ◽  
Narvada Jugnee ◽  
Nick Oliver ◽  
Monika Reddy
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Glycemic Variability ◽  
Clinical Trial Registration ◽  
Freestyle Libre ◽  
The Impact

Background: The I-HART CGM study has shown that real-time continuous glucose monitoring (rtCGM) has greater beneficial impact on hypoglycemia than intermittently scanned continuous glucose monitoring (iscCGM) in adults with type 1 diabetes at high risk (Gold score ≥4 or recent severe hypoglycemia using insulin injections). In this subanalysis, we present the impact of rtCGM and iscCGM on glycemic variability (GV). Methods: Forty participants were recruited to this parallel group study. Following two weeks of blinded rtCGM (DexcomG4), participants were randomized to rtCGM (Dexcom G5; n = 20) or iscCGM (Freestyle Libre; n = 20) for eight weeks. An open-extension phase enabled participants on rtCGM to continue for a further eight weeks and those on iscCGM to switch to rtCGM over this period. Glycemic variability measures at baseline, 8- and 16-week endpoints were compared between groups. Results: At the eight-week endpoint, between-group differences demonstrated significant reduction in several GV measures with rtCGM compared to iscCGM (GRADE%hypoglycemia, index of glycemic control [IGC], and average daily risk range [ADRR]; P < .05). Intermittently scanned continuous glucose monitoring reduced mean average glucose and glycemic variability percentage and GRADE%hyperglycemia compared with rtCGM ( P < .05). At 16 weeks, the iscCGM group switching to rtCGM showed significant improvement in GRADE%hypoglycemia, personal glycemic status, IGC, and ADRR. Conclusion: Our data suggest most, but not all, GV measures improve with rtCGM compared with iscCGM, particularly those measures associated with the risk of hypoglycemia. Selecting appropriate glucose monitoring technology to address GV in this high-risk cohort is important to minimize the risk of glucose extremes and severe hypoglycemia. Clinical trial registration: ClinicalTrials.gov NCT03028220

Significance of “Time below Range” as a Glycemic Marker Derived from Continuous Glucose Monitoring in Japanese Children and Adolescents with Type 1 Diabetes

2020 ◽  
Vol 93 (4) ◽  
pp. 251-257
Author(s):  
Tatsuhiko Urakami ◽  
Kei Yoshida ◽  
Remi Kuwabara ◽  
Yusuke Mine ◽  
Masako Aoki ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Target Range ◽  
Japanese Children ◽  
Mean Frequency ◽  
The Mean

<b><i>Introduction:</i></b> We evaluated the frequencies of various glycemic markers derived from continuous glucose monitoring in Japanese children and adolescents with type 1 diabetes and assessed the significance of hypoglycemia duration. <b><i>Methods:</i></b> We enrolled 85 children and adolescents (36 boys and 49 girls) with type 1 diabetes who used FreeStyle<sup>®</sup> Libre in the present study. Frequencies of blood glucose levels as time within target range (TIR; 70–180 mg/dL), time below target range (TBR; &#x3c;70 mg/dL), time below extreme hypoglycemia range (TBER; &#x3c;54 mg/dL), and time above range (TAR; &#x3e;180 mg/dL) were assessed during a 3-month study period. Furthermore, we evaluated the intraday frequencies of TBR and TBER. <b><i>Results:</i></b> The mean frequencies of TIR, TBR, and TAR were 52.7 ± 11.3%, 10.8 ± 5.4%, and 36.5 ± 10.8%, respectively, whereas the mean frequency of TBER was 1.1 ± 0.9% (0–3.0%); there was no clinical episode of severe hypoglycemia. The mean frequency of TBR was significantly greater in 0–6 h (16.9 ± 5.2%) than in 6–12 h (7.8 ± 2.9%) and 18–24 h (6.8 ± 4.8%; <i>p</i> &#x3c; 0.01) time zones, respectively. <b><i>Discussion/Conclusion:</i></b> We found similar TIR and comparatively higher TBR frequencies, particularly during sleep, than those that were previously reported. Possible reasons for the higher frequency of TBR include differences in the quality of insulin treatment and diabetes care between the present study and the European studies. The utilization of advanced technologies, such as a predictive low-glucose suspend-function pump or closed-loop therapy, can reduce the frequency of TBR, with a consequent increase in TIR frequency and comprehensive improvement in glycemic control.

scholarly journals Real-Time Continuous Glucose Monitoring Significantly Reduces Severe Hypoglycemia in Hypoglycemia-Unaware Patients With Type 1 Diabetes

Diabetes Care ◽  
2013 ◽  
Vol 36 (12) ◽  
pp. 4160-4162 ◽  
Author(s):  
P. Choudhary ◽  
S. Ramasamy ◽  
L. Green ◽  
G. Gallen ◽  
S. Pender ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Real Time ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia
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