scholarly journals Contributions of Fasting and Postprandial Glucose Concentrations to Haemoglobin A1c in Drug-Naïve Mal-Glucose Metabolism in Chinese Population Using Continuous Glucose Monitoring System

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Rengna Yan ◽  
Yun Hu ◽  
Fengfei Li ◽  
Lanlan Jiang ◽  
Xiaohua Xu ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Fasting Glucose ◽  
Glucose Monitoring ◽  
Area Under The Curve ◽  
Postprandial Glucose ◽  
Chinese Patients ◽  
Haemoglobin A1c ◽  
Glucose Levels ◽  
Glucose Testing ◽  
Drug Naïve

Aim. To clarify the contributions of fasting glucose (FG) and postprandial glucose (PG) to HbA1c in drug-naïve patients with type 2 diabetes (T2D) and impaired glucose tolerate (IGT)/impaired fasting glucose (IFG). Methods. Continuous glucose monitoring (CGM) was performed in 305 drug-naïve Chinese patients with T2D or IGT/IFG. The incremental area under the curve (AUC) above a glucose value of 6.1 mmol/L or FG glucose levels were calculated to evaluate the contributions of PG or FG to HbA1c values. Results. According to quintiles of HbA1c, T2D patients were divided into five groups (group 1 to 5), and patients with IGT/IFG were assigned into group 0. PG was the predominant contributor in the lower groups with HbA1c 4.9∼6.0% and 6.1∼7.8%. The relative contributions of FG and PG to HbA1c had no significance in the middle groups of HbA1c (7.9∼8.7% and 8.8∼9.5%). FG contributed significantly more than PG in the higher groups of HbA1c (9.6∼10.9% and 11.0∼14.6%). Regression analyses indicate that the contributions of FG and PG were equal (both 50%) when the level of HbA1c was 8.5%. Conclusions. In drug-naïve patients with T2D or IGT/IFG, PG contributed more in patients with HbA1c < 8.5%, whereas FG became the predominant contributor in the poorly controlled patients with HbA1c ≥ 8.5%. These results may help the health-care provider set appropriate plasma glucose testing goals with the expectation of achieving specific HbA1c values.

Effects of high-intensity interval exercise versus continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose monitoring in obese adults

2014 ◽  
Vol 39 (7) ◽  
pp. 835-841 ◽  
Author(s):  
Jonathan P. Little ◽  
Mary E. Jung ◽  
Amy E. Wright ◽  
Wendi Wright ◽  
Ralph J.F. Manders
Keyword(s):  
Continuous Glucose Monitoring ◽  
High Intensity ◽  
Glucose Monitoring ◽  
Area Under The Curve ◽  
Postprandial Glucose ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Obese Adults ◽  
High Intensity Interval ◽  
The Impact

The purpose of this study was to examine the impact of acute high-intensity interval training (HIIT) compared with continuous moderate-intensity (CMI) exercise on postprandial hyperglycemia in overweight or obese adults. Ten inactive, overweight or obese adults (41 ± 11 yrs, BMI = 36 ± 7 kg/m2) performed an acute bout of HIIT (10 × 1 min at approximately 90% peak heart rate (HRpeak) with 1-min recovery periods) or matched work CMI (30 min at approximately 65% HRpeak) in a randomized, counterbalanced fashion. Exercise was performed 2 h after breakfast, and glucose control was assessed by continuous glucose monitoring under standardized dietary conditions over 24 h. Postprandial glucose (PPG) responses to lunch, dinner, and the following day’s breakfast were analyzed and compared with a no-exercise control day. Exercise did not affect the PPG responses to lunch, but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve (AUC) following dinner when compared with control (HIIT = 110 ± 35, CMI = 125 ± 34, control = 162 ± 46 mmol/L × 2 h, p < 0.05). The PPG AUC (HIIT = 125 ± 53, CMI = 186 ± 55, control = 194 ± 96 mmol/L × 2 h) and the PPG spike (HIIT = Δ2.1 ± 0.9, CMI = Δ3.0 ± 0.9, control = Δ3.0 ± 1.5 mmol/l) following breakfast on the following day were significantly lower following HIIT compared with both CMI and control (p < 0.05). Absolute AUC and absolute glucose spikes were not different between HIIT, CMI, or control for any meal (p > 0.05 for all). We conclude that a single session of HIIT has greater and more lasting effects on reducing incremental PPG when compared with CMI.

scholarly journals Determination of Postprandial Glycemic Responses by Continuous Glucose Monitoring in a Real-World Setting

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2305
Author(s):  
Röhling ◽  
Martin ◽  
Wonnemann ◽  
Kragl ◽  
Klein ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Fasting Blood Glucose ◽  
Glucose Monitoring ◽  
Postprandial Glucose ◽  
Postprandial Blood Glucose ◽  
Oral Glucose ◽  
White Bread ◽  
Whole Grain ◽  
Glucose Testing

Background: Self-monitoring of blood glucose using capillary glucose testing (C) has a number of shortcomings compared to continuous glucose monitoring (CGM). We aimed to compare these two methods and used blood glucose measurements in venous blood (IV) as a reference. Postprandial blood glucose levels were measured after 50 g oral glucose load and after the consumption of a portion of different foods containing 50 g of carbohydrates. We also evaluated the associations between postprandial glucose responses and the clinical characteristics of the participants at the beginning of the study. Methods: 12 healthy volunteers (age: 36 ± 17 years, BMI: 24.9 ± 3.5 kg/m²) ate white bread (WB) and whole grain (WG) bread and drank a 50 g glucose drink as reference. Postprandial glucose responses were evaluated by CGM, IV and C blood glucose measurements. Incremental area under the curve (AUCi) of postprandial blood glucose was calculated for 1 h (AUCi 0-60) and 2 h (AUCi 0-120). Results: After the consumption of white bread and whole grain bread, the AUCi 0-60 min did not differ between CGM and IV or C. AUCi 0-120 min of CGM showed no difference compared to C. Correlation analyses revealed a positive association of age with glucose AUCi 0-120 (r = 0.768; P = 0.004) and WG AUCi 0-120 (r = 0.758; P = 0.004); fasting blood glucose correlated with WG AUCi 0-120 (r = 0.838; P < 0.001). Conclusion: Despite considerable inter-individual variability of postprandial glycemic responses, CGM evaluated postprandial glycemic excursions which had comparable results compared to standard blood glucose measurements under real-life conditions. Associations of AUCi 0-60 and AUCi 0-120 postprandial glucose response with age or fasting blood glucose could be shown.

scholarly journals The Effect of Exercise Timing on Elevated Postprandial Glucose in Women With Obesity

2021 ◽  
Vol 24 (3) ◽  
pp. 334-347
Author(s):  
Fateme Dehghani Yunarti1 ◽  
◽  
Vazgen Minasian ◽  
Keyword(s):  
Aerobic Exercise ◽  
Continuous Glucose Monitoring ◽  
Exercise Intervention ◽  
Glucose Monitoring ◽  
Postprandial Glucose ◽  
Moderate Intensity ◽  
Control Group ◽  
Glucose Levels ◽  
Exercise Timing ◽  
Main Meal

Background and Aim: This study aimed to investigate the effect of exercise timing on elevated postprandial glucose and after brief interval exercises in women with obesity. Methods & Materials: Ten women with obesity (Mean±SD age = 40.41±3.97 years; weight = 86.66±7.26 kg; and BMI = 33.22±2.20 kg/m2) participated in a crossover design exercise intervention: 1) postprandial aerobic exercise, 2) pre-prandial aerobic exercise, 3) brief periodic exercise, and 4) control. Pre- and postprandial exercise included 30 min of moderate-intensity walking on the treadmill before and after each main meal (1 minute of exercise -30 seconds rest). The brief periodic exercise had three one-minute reps of activity every 30 min for 20 times during the day. Twelve-hour continuous glucose monitoring and two-hour postprandial glucose levels were calculated to examine changes in blood glucose levels. Ethical Considerations: This study was approved by the institutional review board of the University of Isfahan (Ethics Code: IR.UI.REC.1397.119) and conducted in agreement with the ethical principles for biomedical research involving human subjects outlined in the declaration of Helsinki. Results: The findings of this study suggested that brief periodic exercise resulted in a significant decrease in continuous glucose monitoring levels and postprandial glucose compared to the control group as well as pre-prandial exercise (P˂0.05). However, pre- and postprandial exercise did not result in significant changes in continuous glucose monitoring (P˃0.05). In addition, postprandial exercise led to a significant decrease in postprandial glucose compared to the control group (P˂0.05). Conclusion: It seems that brief periodic exercise can have more beneficial effects on postprandial glucose levels, probably due to improved glucose metabolism in skeletal muscle.

scholarly journals Assessment of Hyperglycemia, Hypoglycemia and Inter-Day Glucose Variability Using Continuous Glucose Monitoring among Diabetic Patients on Chronic Hemodialysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4116
Author(s):  
Maria Divani ◽  
Panagiotis I. Georgianos ◽  
Triantafyllos Didangelos ◽  
Vassilios Liakopoulos ◽  
Kali Makedou ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Area Under The Curve ◽  
Glucose Variability ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Diabetic Patients ◽  
Lower Efficiency ◽  
Target Glucose

Continuous glucose monitoring (CGM) facilitates the assessment of short-term glucose variability and identification of acute excursions of hyper- and hypo-glycemia. Among 37 diabetic hemodialysis patients who underwent 7-day CGM with the iPRO2 device (Medtronic Diabetes, Northridge, CA, USA), we explored the accuracy of glycated albumin (GA) and hemoglobin A1c (HbA1c) in assessing glycemic control, using CGM-derived metrics as the reference standard. In receiver operating characteristic (ROC) analysis, the area under the curve (AUC) in diagnosing a time in the target glucose range of 70–180 mg/dL (TIR70–180) in <50% of readings was higher for GA (AUC: 0.878; 95% confidence interval (CI): 0.728–0.962) as compared to HbA1c (AUC: 0.682; 95% CI: 0.508–0.825) (p < 0.01). The accuracy of GA (AUC: 0.939; 95% CI: 0.808–0.991) in detecting a time above the target glucose range > 250 mg/dL (TAR>250) in >10% of readings did not differ from that of HbA1c (AUC: 0.854; 95% CI: 0.699–0.948) (p = 0.16). GA (AUC: 0.712; 95% CI: 0.539–0.848) and HbA1c (AUC: 0.740; 95% CI: 0.570–0.870) had a similarly lower efficiency in detecting a time below target glucose range < 70 mg/dL (TBR<70) in >1% of readings (p = 0.71). Although the mean glucose levels were similar, the coefficient of variation of glucose recordings (39.2 ± 17.3% vs. 32.0 ± 7.8%, p < 0.001) and TBR<70 (median (range): 5.6% (0, 25.8) vs. 2.8% (0, 17.9)) were higher during the dialysis-on than during the dialysis-off day. In conclusion, the present study shows that among diabetic hemodialysis patients, GA had higher accuracy than HbA1c in detecting a 7-day CGM-derived TIR70–180 < 50%. However, both biomarkers provided an imprecise reflection of acute excursions of hypoglycemia and inter-day glucose variability.

Utility of Continuous Glucose Monitoring vs. Meal Study in Detecting Hypoglycemia After Gastric Bypass

2021 ◽  
Author(s):  
Henri Honka ◽  
Janet Chuang ◽  
David D’Alessio ◽  
Marzieh Salehi
Keyword(s):  
Gastric Bypass ◽  
Continuous Glucose Monitoring ◽  
Gastric Bypass Surgery ◽  
Late Complication ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Postprandial Glucose ◽  
Healthy Weight ◽  
Free Living ◽  
Carbohydrate Ingestion

Abstract Context Gastric bypass (GB) increases postprandial glucose excursion, which in turn can predispose to the late complication of hypoglycemia. Diagnosis remains challenging and requires documentation of symptoms associated with low glucose, and relief of symptom when glucose is normalized (Whipple’s triad). Objective To compare the yield of mixed meal test (MMT) and continuous glucose monitoring system (CGMS) in detecting hypoglycemia after gastric bypass surgery (GB). Setting The study was conducted at General Clinical Research Unit, Cincinnati Children’s Hospital (Cincinnati, OH, United States). Methods Glucose profiles were evaluated in 15 patients with documented recurrent clinical hypoglycemia after GB, 8 matched asymptomatic GB subjects, and 9 healthy weight-matched non-operated controls using MMT in a control setting and CGMS under free-living conditions. Results Patients with prior GB had larger glucose variability during both MMT and CGMS when compared to non-surgical controls regardless of their hypoglycemic status. Sensitivity (71 vs. 47 %) and specificity (100 vs. 88 %) of MMT in detecting hypoglycemia was superior to CGMS. Conclusions Our findings indicate that a fixed carbohydrate ingestion during MMT is a more reliable test to diagnose GB-related hypoglycemia compared to CGMS during free-living state.

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