scholarly journals Factors Predictive of Severe Hypoglycemia in Type 1 Diabetes: Analysis from the Juvenile Diabetes Research Foundation continuous glucose monitoring randomized control trial dataset

Diabetes Care ◽  
2011 ◽  
Vol 34 (3) ◽  
pp. 586-590 ◽  
Author(s):  
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Randomized Control Trial ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Juvenile Diabetes ◽  
Diabetes Research ◽  
Randomized Control

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.

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.

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