Defining Glycemic Variability in Very Low-Birthweight Infants: Data from a Continuous Glucose Monitoring System

2018 ◽  
Vol 20 (11) ◽  
pp. 725-730 ◽  
Author(s):  
Mateusz Jagła ◽  
Izabela Szymońska ◽  
Katarzyna Starzec ◽  
Olga Gach ◽  
Aneta Włodarczyk ◽  
...  
Keyword(s):  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Low Birthweight ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Continuous Glucose Monitoring System ◽  
Very Low Birthweight ◽  
Very Low Birthweight Infants

Peritoneal dialysis – risk factor for glycemic variability assessed by continuous glucose monitoring system

2014 ◽  
Vol 21 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Simona Popa ◽  
Cristina Văduva ◽  
Maria Moţa ◽  
Eugen Moţa
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Continuous Glucose Monitoring System ◽  
Diabetic Patients ◽  
Type 2 Diabetic

Abstract Background and Aims. Peritoneal dialysis (PD) is accompanied by a multitude of factors that influence glycemic variability, and HbA1c does not detect dynamic glucose changes. In this study we wanted to assess glycemic variability, using a 72-hour continuous glucose monitoring system (CGMS), in 31 patients stratified according to the presence of type 2 diabetes and PD. Materials and Methods. The study included 31 patients (11 type 2 diabetic PD patients, 9 non diabetic PD patients and 11 type 2 diabetic patients without PD). Glycemic variability was assessed on CGM readings by: Mean Amplitude of Glycemic Excursion (MAGE), Mean of Daily Differences (MODD), Fractal Dimensions (FD), Mean Interstitial Glucose (MIG), Area Under glycemia Curve (AUC), M100, % time with glucose >180/<70 mg/dl. Results. The PD diabetic patients presented AUC, MIG and inter-day glycemic variability (MODD) significantly higher than diabetic patients without PD. In PD patients, the type of dialysis fluid in the nocturnal exchange and peritoneal membrane status did not significantly influence glycemic variability. Conclusions. CGMS is more useful than HbA1c in quantifying the metabolic imbalance of PD patients. PD induces inter-day glycemic variability and poor glycemic control, thus being a potential risk factor for chronic complications progression in diabetic patients.

scholarly journals Glycemic Variability Assessment with a 14-Day Continuous Glucose Monitoring System: When and How Long to Measure MAGE (Mean Amplitude of Glucose Excursion) for Optimal Reliability?

2021 ◽  
pp. 193229682199206
Author(s):  
Bruno Vergès ◽  
Elise Pignol ◽  
Alexia Rouland ◽  
Benjamin Bouillet ◽  
Sabine Baillot-Rudoni ◽  
...  
Keyword(s):  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Continuous Glucose Monitoring System ◽  
Glucose Excursion ◽  
Additional Information ◽  
Time Period

Mean amplitude of glucose excursion (MAGE) is considered as the “gold standard” for assessing the short-term within-day glycemic variability (GV), which is an important component of overall glycemic control. A 14-day continuous glucose monitoring system is now widely used and allows easier assessment of GV. However, it is still unknown whether MAGE, usually calculated on a 48-hour period is identical whatever the time during the 14-day lifespan of the sensor and whether a longer time period might give additional information. We evaluated in 68 patients with type 1 diabetes, MAGE during three 2-day periods (day1-day3; day6-day8; day11-day13) and during periods of 3 days and 4 days. MAGE calculated at the three 2-day periods were identical and not different from MAGE of the 3-day or 4-day periods.

Strict glycaemic control in very low birthweight infants using a continuous glucose monitoring system: a randomised controlled trial

2021 ◽  
pp. fetalneonatal-2020-320540
Author(s):  
Alessandro Perri ◽  
Eloisa Tiberi ◽  
Lucia Giordano ◽  
Annamaria Sbordone ◽  
Maria Letizia Patti ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Glycaemic Control ◽  
Continuous Glucose Monitoring ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Intervention Group ◽  
Glucose Monitoring ◽  
Very Low Birthweight ◽  
Very Low Birthweight Infants ◽  
Randomised Controlled

ObjectiveTo evaluate the efficacy of a strict glycaemic control protocol using a continuous glucose monitoring (CGM) in infants at high risk of dysglycaemia with the aim of reducing the number of dysglycaemic episodes.DesignRandomised controlled trial.SettingNeonatal intensive care unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome.PatientsAll infants <1500 g fed on parental nutrition (PN) since birth were eligible. A total of 63 infants were eligible and 48 were randomised.InterventionAll participants wore a CGM sensor and were randomised in two arms with alarms set at different cut-off values (2.61–10 mmol/L (47–180 mg/dL) vs 3.44–7.78 mmol/L (62–140 mg/dL)), representing the operative threshold requiring modulation of glucose infusion rate according to an innovative protocol.Main outcome measuresThe primary outcome was the number of severe dysglycaemic episodes (<2.61 mmol/L (47 mg/dL) or >10 mmol/L (180 mg/dL)) in the intervention group versus the control group, during the monitoring time.ResultsWe enrolled 47 infants, with similar characteristics between the two arms. The number of dysglycaemic episodes and of infants with at least one episode of dysglycaemia was significantly lower in the intervention group (strict group): respectively, 1 (IQR 0–2) vs 3 (IQR 1–7); (p=0.005) and 12 (52%) vs 20 (83%); p=0.047. Infants managed using the strict protocol had a higher probability of having normal glycaemic values: relative risk 2.87 (95% CI 1.1 to 7.3). They spent more time in euglycaemia: 100% (IQR 97–100) vs 98% (IQR 94–99), p=0.036. The number needed to treat to avoid dysglycaemia episodes is 3.2 (95% CI 1.8 to 16.6).ConclusionWe provide evidence that CGM, combined with a protocol for adjusting glucose infusion, can effectively reduce the episodes of dysglycaemia and increase the percentage of time spent in euglycaemia in very low birthweight infants receiving PN in the first week of life.

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