scholarly journals Hemoglobin A1c and Mean Glucose in Patients With Type 1 Diabetes: Analysis of data from the Juvenile Diabetes Research Foundation continuous glucose monitoring randomized trial

Diabetes Care ◽  
2011 ◽  
Vol 34 (3) ◽  
pp. 540-544 ◽  
Author(s):  
Keyword(s):  
Type 1 Diabetes ◽  
Randomized Trial ◽  
Continuous Glucose Monitoring ◽  
Hemoglobin A1c ◽  
Glucose Monitoring ◽  
Juvenile Diabetes ◽  
Diabetes Research ◽  
Mean Glucose

scholarly journals Eight-Point Glucose Testing Versus the Continuous Glucose Monitoring System in Evaluation of Glycemic Control in Type 1 Diabetes

2005 ◽  
Vol 90 (6) ◽  
pp. 3387-3391 ◽  
Keyword(s):  
Type 1 Diabetes ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Hemoglobin A1c ◽  
Glucose Monitoring ◽  
Continuous Glucose Monitoring System ◽  
Diabetes Research ◽  
Glucose Profiles ◽  
Mean Glucose

Context: Advantages/disadvantages of continuous vs. discrete glucose monitoring are not well documented. Objective: Compare glucose profiles from home meters vs. continuous sensors. Design: Randomized clinical trial conducted by the Diabetes Research in Children Network (DirecNet) to assess the utility of the GlucoWatch G2 Biographer. Setting: Home glucose measurements. Patients: Two hundred children (age, 7 to < 18 yr) with type 1 diabetes. Intervention: At baseline, subjects were asked to wear the continuous glucose monitoring system (CGMS) sensor and perform meter tests at eight prespecified times of the day (eight-point testing) each for 3 d (2 d using both, 1 d eight-point testing only, 1 d CGMS only). Hemoglobin A1c was measured in a central laboratory. Main Outcome Measure: Six-month hemoglobin A1c. This analysis looked at baseline glucose profiles/hemoglobin A1c. Results: Only 10% of subjects completed full eight-point testing for 3 d, but median CGMS use was 70 h. Mean glucose was lower when measured by the CGMS compared with eight-point testing (183 ± 37 vs. 188 ± 41 mg/dl; 10.2 ± 2.1 vs.10.4 ± 2.3 mmol/liter; P = 0.009), especially overnight (2400–0400 h; 174 vs. 199 mg/dl; 9.7 vs. 11.1 mmol/liter; P < 0.001). Associations of hemoglobin A1c with mean glucose were similar for eight-point testing [slope 23 mg/dl per 1% (1.3 mmol/liter); correlation 0.40; P < 0.001] and CGMS [slope 19 mg/dl per 1% (1.1 mmol/liter); correlation 0.39; P < 0.001]. Postprandial excursions were lower for eight-point testing vs. CGMS, especially after dinner (mean excursion −17 vs. 63 mg/dl; −1.0 vs. 3.5 mmol/liter; P < 0.001). Conclusions: Both methods gave similar mean glucose profiles and associations with hemoglobin A1c. Advantages of the CGMS were higher density of data and better detection of postprandial peaks. However, the CGMS may overestimate the frequency of low glucose levels, especially overnight.

scholarly journals Effects of Glucose Control and Variability on Endothelial Function and Repair in Adolescents with Type 1 Diabetes

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Robert P. Hoffman ◽  
Amanda S. Dye ◽  
Hong Huang ◽  
John A. Bauer
Keyword(s):  
Type 1 Diabetes ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Hemoglobin A1c ◽  
Glucose Monitoring ◽  
Area Under The Curve ◽  
Vascular Occlusion ◽  
Venous Occlusion ◽  
Mean Glucose

Background. Endothelial dysfunction and increased inflammation are precursors of cardiovascular disease in type 1 diabetes (T1D) and occur even in adolescents with T1D. The goal of this study was to determine the relationship of endothelial dysfunction to various measures of glycemia. Research Design and Methods. Forearm blood flow (FBF, venous occlusion plethysmography) was measured before and after 5 min of upper arm vascular occlusion in 17 adolescents with uncomplicated type 1 diabetes. Endothelial function was assessed as postocclusion FBF and forearm vascular resistance (FVR, mean arterial pressure/FBF). Fasting glucose, 72 hour mean glucose and standard deviation from continuous glucose monitoring, hemoglobin A1c, and hemoglobin A1c by duration area under the curve were used to assess immediate, short-term, and intermediate- and long-term glycemia. Results. Postocclusion FBF (r=-0.53, P=0.030) negatively correlated and postocclusion FVR positively correlated (r=0.52, P=0.031) with hemoglobin A1c levels. FVR was positively associated with log 3 day mean glucose (r=0.55, P=0.027). Postocclusion FBF (2.8±1.1 versus 3.4±0.5 mL/dL/min, mean ± SE, P=0.084) tended to be lower and FVR (31.4±10.4 versus 23.9±4.4 mmHg dL min/mL, P=0.015) was significantly higher in subjects with hemoglobin A1c above the median (8.3%) compared to those with lower hemoglobin A1c levels. Conclusions. These results demonstrate that poor intermediate-term glycemic control is associated with impaired endothelial function.

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