scholarly journals Effects of a sodium glucose co‐transporter 2 selective inhibitor, ipragliflozin, on the diurnal profile of plasma glucose in patients with type 2 diabetes: A study using continuous glucose monitoring

2015 ◽  
Vol 6 (6) ◽  
pp. 699-707 ◽  
Author(s):  
Kentaro Yamada ◽  
Hitomi Nakayama ◽  
Satoko Yoshinobu ◽  
Seiko Kawano ◽  
Munehisa Tsuruta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Plasma Glucose ◽  
Glucose Monitoring ◽  
Selective Inhibitor ◽  
Diurnal Profile

The Accuracy of Hemoglobin A1c and Fructosamine Evaluated by Long-Term Continuous Glucose Monitoring in Patients with Type 2 Diabetes Undergoing Hemodialysis

2021 ◽  
pp. 1-9
Author(s):  
Tobias Bomholt ◽  
Marianne Rix ◽  
Thomas Almdal ◽  
Filip K. Knop ◽  
Susanne Rosthøj ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Plasma Glucose ◽  
Hemoglobin A1c ◽  
Glucose Monitoring ◽  
Control Group ◽  
Glucose Levels ◽  
Sensor Glucose

<b><i>Introduction:</i></b> The accuracy of hemoglobin A1c (HbA1c) as a glycemic marker in patients with type 2 diabetes (T2D) receiving hemodialysis (HD) remains unknown. To assess accuracy, we compared HbA1c and fructosamine levels with interstitial glucose measured by continuous glucose monitoring (CGM) in patients with T2D receiving HD. <b><i>Methods:</i></b> Thirty patients in the HD group and 36 patients in the control group (T2D and an estimated glomerular filtration rate &#x3e;60 mL/min/1.73 m<sup>2</sup>) completed the study period of 17 weeks. CGM (Ipro2<sup>®</sup>, Medtronic) was performed 5 times for periods of up to 7 days (with 4-week intervals) during a 16-week period. HbA1c (mmol/mol), the estimated mean plasma glucose from HbA1c (eMPGA1c [mmol/L]) and fructosamine (μmol/L) was measured at week 17 and compared with mean sensor glucose levels from CGM. <b><i>Findings:</i></b> In the HD group, mean sensor glucose was 1.4 mmol/L (95% confidence interval [CI]: 1.0–1.8) higher than the eMPGA1c, whereas the difference for controls was 0.1 mmol/L (95% CI: −0.1–[0.4]; <i>p</i> &#x3c; 0.001). Adjusted for mean sensor glucose, HbA1c was lower in the HD group (−7.3 mmol/mol, 95% CI: −10.0–[−4.7]) than in the control group (<i>p</i> &#x3c; 0.001), with no difference detected for fructosamine (<i>p</i> = 0.64). <b><i>Discussion:</i></b> HbA1c evaluated by CGM underestimates plasma glucose levels in patients receiving HD. The underestimation represents a clinical challenge in optimizing glycemic control in the HD population. Fructosamine is unaffected by the factors affecting HbA1c and appears to be more accurate for glycemic monitoring. CGM or fructosamine could thus complement HbA1c in obtaining more accurate glycemic control in this patient group.

Hemoglobin A1c and Fructosamine Evaluated in Patients with Type 2 Diabetes Receiving Peritoneal Dialysis Using Long-Term Continuous Glucose Monitoring

Nephron ◽  
2021 ◽  
pp. 1-7
Author(s):  
Tobias Bomholt ◽  
Bo Feldt-Rasmussen ◽  
Rizwan Butt ◽  
Rikke Borg ◽  
Mir Hassan Sarwary ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peritoneal Dialysis ◽  
Continuous Glucose Monitoring ◽  
Plasma Glucose ◽  
Glucose Monitoring ◽  
Control Group ◽  
Glucose Levels ◽  
Sensor Glucose ◽  
Interstitial Glucose

<b><i>Introduction:</i></b> Shortened erythrocyte life span and erythropoietin-stimulating agents may affect hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels in patients receiving peritoneal dialysis (PD). We compared HbA<sub>1c</sub> with interstitial glucose measured by continuous glucose monitoring (CGM) in patients with type 2 diabetes receiving PD. <b><i>Methods:</i></b> Fourteen days of CGM (Ipro2, Medtronic) were performed in 23 patients with type 2 diabetes receiving PD and in 23 controls with type 2 diabetes and an estimated glomerular filtration rate over 60 mL/min/1.73 m<sup>2</sup>. Patients were matched on gender and age (±5 years). HbA<sub>1c</sub> (mmol/mol), its derived estimate of mean plasma glucose (eMPG<sub>A1c</sub>) (mmol/L), and fructosamine (µmol/L) were measured at the end of the CGM period and compared with the mean sensor glucose (mmol/L) from CGM. <b><i>Results:</i></b> In the PD group, mean sensor glucose was 0.98 (95% con­fidence interval (CI): 0.43–1.54) mmol/L higher than the eMPG<sub>A1c</sub> compared with the control group (<i>p</i> = 0.002) where glucose levels were nearly identical (−0.05 (95% CI: −0.35–0.25) mmol/L). A significant association was found between fructosamine and mean sensor glucose using linear regression with no difference between slopes (<i>p</i> = 0.89) or y-intercepts (<i>p</i> = 0.28). <b><i>Discussion/Conclusion:</i></b> HbA<sub>1c</sub> underestimates mean plasma glucose levels in patients with type 2 diabetes receiving PD. However, the clinical significance of this finding is undetermined. Fructosamine seems to more accurately reflect glycemic status. CGM or fructosamine could complement HbA<sub>1c</sub> to increase the accuracy of glycemic monitoring in the PD population.

Comparing Patch vs. Pen Bolus Insulin Delivery in Type 2 Diabetes Using Continuous Glucose Monitoring Metrics and Profiles

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 73-LB
Author(s):  
MARY L. JOHNSON ◽  
DARLENE M. DREON ◽  
BRIAN L. LEVY ◽  
SARA RICHTER ◽  
DEBORAH MULLEN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Insulin Delivery ◽  
Bolus Insulin

973-P: The Feasibility of Continuous Glucose Monitoring in Youth with Type 2 Diabetes Mellitus: A Pilot Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 973-P
Author(s):  
ALLISON LAROCHE ◽  
KRISTINA UTZSCHNEIDER ◽  
CATHERINE PIHOKER
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pilot Study ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring

2180-PUB: Integration of Continuous Glucose Monitoring in Diabetes Self-Management Education for Type 2 Diabetes Improves Glycemic Control

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2180-PUB
Author(s):  
ADDIE L. FORTMANN ◽  
ALESSANDRA BASTIAN ◽  
CODY J. LENSING ◽  
SHANE HOVERSTEN ◽  
KIMBERLY LUU ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Management Education ◽  
Glucose Monitoring ◽  
Self Management

scholarly journals The effects of professional continuous glucose monitoring as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dulce Adelaida Rivera-Ávila ◽  
Alejandro Iván Esquivel-Lu ◽  
Carlos Rafael Salazar-Lozano ◽  
Kyla Jones ◽  
Svetlana V. Doubova
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Outcome Variable ◽  
Control Group ◽  
Educational Tool ◽  
Study Objective ◽  
Hba1c Levels

Abstract Background The study objective was to evaluate the effects of professional continuous glucose monitoring (CGM) as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes (T2D). Methods We conducted a three-month quasi-experimental study with an intervention (IGr) and control group (CGr) and ex-ante and ex-post evaluations in one family medicine clinic in Mexico City. Participants were T2D patients with HbA1c > 8% attending a comprehensive diabetes care program. In addition to the program, the IGr wore a professional CGM sensor (iPro™2) during the first 7 days of the study. Following this period, IGr participants had a medical consultation for the CGM results and treatment adjustments. Additionally, they received an educational session and personalized diet plan from a dietitian. After 3 months, the IGr again wore the CGM sensor for 1 week. The primary outcome variable was HbA1c level measured at baseline and 3 months after the CGM intervention. We analyzed the effect of the intervention on HbA1c levels by estimating the differences-in-differences treatment effect (Diff-in-Diff). Additionally, baseline and three-month CGM and dietary information were recorded for the IGr and analyzed using the Student’s paired t-test and mixed-effects generalized linear models to control for patients’ baseline characteristics. Results Overall, 302 T2D patients participated in the study (IGr, n = 150; control, n = 152). At the end of the three-month follow-up, we observed 0.439 mean HbA1C difference between groups (p = 0.004), with an additional decrease in HbA1c levels in the IGr compared with the CGr (Diff-in-Diff HbA1c mean of − 0.481% points, p = 0.023). Moreover, compared with the baseline, the three-month CGM patterns showed a significant increase in the percentage of time in glucose range (+ 7.25; p = 0.011); a reduction in the percentage of time above 180 mg/dl (− 6.01; p = 0.045), a decrease in glycemic variability (− 3.94, p = 0.034); and improvements in dietary patterns, shown by a reduction in total caloric intake (− 197.66 Kcal/day; p = 0.0001). Conclusion Professional CGM contributes to reducing HbA1c levels and is an adjuvant educational tool that can improve glycemic control in patients with T2D. Trial registration ClinicalTrials.gov: NCT04667728. Registered 16/12/2020

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