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 Pengaruh lama mengunyah terhadap kadar glukosa postprandial dewasa obesitas

2020 ◽  
Vol 8 (1) ◽  
pp. 24
Author(s):  
Arin Wulansari ◽  
Fryta Ameilia Luthfinnisa ◽  
Fuadah Uyun ◽  
Dwi Retnoningrum ◽  
Fifin Luthfia Rahmi ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Postprandial Glucose ◽  
Postprandial Blood Glucose ◽  
Glucose Levels ◽  
Glucose Testing ◽  
Blood Glucose Levels ◽  
Cephalic Phase ◽  
Significant Difference ◽  
The Mean

Background: Obesity cause various physiological changes in the body, one of which is insulin resistance causes high blood glucose levels. Chewing is a stimulus of cephalic phase responses and sensory stimulation that can increase hormones releasing such as insulin, ghrelin, cholecystokinin (CCK) and glucagon like peptide-1 (GLP-1). Chewing plays important role in determining postprandial plasma glucose concentration.Objective: Investigate the effect of chewing on postprandial blood glucose in obese adults.Method: This was true experimental research. Research subjects were treated in the form of chewing 22 times and 40 times each mouthful. Blood glucose levels were measured using glucometer on fasting blood glucose and postprandial blood glucose 15 minutes, 30 minutes, 60 minutes, and 120 minutes. Statistical test using Independent t-test.Results: The mean postprandial glucose levels in the 22 chews group at 15 minutes, 30 minutes, 60 minutes, and 120 minutes were 112.11 ± 14.3328, 126.11 ± 15.667, 116.94 ± 15.539, and 89.67 ± 11.668 . While the mean postprandial blood glucose levels in the 40 chews group at 15 minutes, 30 minutes, 60 minutes, and 120 minutes were 122.22 ± 14.381, 129.61 ± 15.112, 109.50 ± 14.995, and 85.83 ± 13.963. There were statistically significant differences between chewing groups 22 times and chewing 40 times on fasting blood glucose and 15 minutes postprandial blood glucose (p = 0.041 and p = 0.042), while on 30 minutes postprandial glucose testing, 60 minutes , and 120 minutes there was no significant difference (p> 0.05).Conclusion: There was significant differences in 15 minutes postprandial blood glucose level between group 22 times chewing and 40 times chewing each mouthful.

scholarly journals Clinical Update on Optimal Prandial Insulin Dosing Using a Refined Run-to-Run Control Algorithm

2009 ◽  
Vol 3 (3) ◽  
pp. 487-491 ◽  
Author(s):  
Howard Zisser ◽  
Cesar C. Palerm ◽  
Wendy C. Bevier ◽  
Francis J. Doyle ◽  
Lois Jovanovic
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Concentration ◽  
Fasting Blood Glucose ◽  
Glucose Monitoring ◽  
Postprandial Glucose ◽  
Carbohydrate Content ◽  
Postprandial Blood Glucose ◽  
Glucose Levels ◽  
Prandial Insulin ◽  
Blood Glucose Levels

Background: This article provides a clinical update using a novel run-to-run algorithm to optimize prandial insulin dosing based on sparse glucose measurements from the previous day's meals. The objective was to use a refined run-to-run algorithm to calculate prandial insulin-to-carbohydrate ratios (I:CHO) for meals of variable carbohydrate content in subjects with type 1 diabetes (T1DM). Method: The open-labeled, nonrandomized study took place over a 6-week period in a nonprofit research center. Nine subjects with T1DM using continuous subcutaneous insulin infusion participated. Basal insulin rates were optimized using continuous glucose monitoring, with a target fasting blood glucose of 90 mg/dl. Subjects monitored blood glucose concentration at the beginning of the meal and at 60 and 120 minutes after the start of the meal. They were instructed to start meals with blood glucose levels between 70 and 130 mg/dl. Subjects were contacted daily to collect data for the previous 24-hour period and to give them the physician-approved, algorithm-derived I:CHO ratios for the next 24 hours. Subjects calculated the amount of the insulin bolus for each meal based on the corresponding I:CHO and their estimate of the meal's carbohydrate content. One- and 2-hour postprandial glucose concentrations served as the main outcome measures. Results: The mean 1-hour postprandial blood glucose level was 104 ± 19 mg/dl. The 2-hour postprandial levels (96.5 ± 18 mg/dl) approached the preprandial levels (90.1 ± 13 mg/dl). Conclusions: Run-to-run algorithms are able to improve postprandial blood glucose levels in subjects with T1DM.

scholarly journals Case Report: A Novel ABCC8 Variant in a Chinese Pedigree of Maturity-Onset Diabetes of the Young

2021 ◽  
Vol 12 ◽  
Author(s):  
Chaoyan Tang ◽  
Liheng Meng ◽  
Ping Zhang ◽  
Xinghuan Liang ◽  
Chaozhi Dang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Homeostasis ◽  
Fasting Blood Glucose ◽  
Family Members ◽  
Missense Variant ◽  
Postprandial Blood Glucose ◽  
Chinese Family ◽  
Oral Glucose ◽  
Maturity Onset Diabetes ◽  
Onset Diabetes

BackgroundWe aimed to analyze a novel ABCC8 variant of a Chinese patient with suspected maturity-onset diabetes of the young (MODY) and to provide evidence for precise diagnosis and appropriate treatment.MethodA Chinese family with suspected MODY was recruited in this study, which included a 15-year-old female patient with diabetes. Clinical data and blood samples were collected from the proband and other family members. All of the living relatives were given an oral glucose tolerance test. Next-generation sequencing was performed to identify the mutated genes in the proband. Sanger sequencing was utilized to confirm the location of the pathogenic variant in all subjects. Further treatment was referred to targeted family members according to genetic testing.ResultsThe proband was found to have a random blood glucose level of 244.8 mg/dl and an HbA1c level of 9.2%. Before this investigation, her grandparents had been diagnosed with diabetes. The second uncle, two aunts, mother, and cousin of the proband were diagnosed with diabetes by abnormal HbA1C (6.5–12.1%) and fasting blood glucose (FBG, 91.4–189.7 mg/dl). The second aunt of the proband had impaired glucose homeostasis (HbA1C = 6.4% and FBG = 88.0 mg/dl). One novel missense variant c.1432G&gt;A (p.A478T) in exon 9 of the ABCC8 gene was detected in the proband with suspected MODY. The variant was also found in six family members with diabetes or impaired glucose homeostasis, including her second uncle, two aunts, mother, and cousin. After the treatment was switched to glimepiride, the fasting blood glucose was adjusted to 99.54 mg/dl, the 2-h postprandial blood glucose was 153.54 mg/dl, serum fructosamine was 259 μmol/l, and HbA1c was 5.8%. The glycemic control remained optimal, and no hypoglycemic episodes were observed in the living relatives.ConclusionThis study revealed one novel missense variant of the ABCC8 gene in Chinese families. The present findings indicated that the members of this family responded to treatment with sulfonylureas as previously seen in ABCC8 MODY.

scholarly journals Accuracy of continuous glucose monitoring in preterm infants: a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e045335
Author(s):  
Chiara Nava ◽  
Astrid Modiano Hedenmalm ◽  
Franciszek Borys ◽  
Lotty Hooft ◽  
Matteo Bruschettini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Glucose ◽  
Diagnostic Accuracy ◽  
Preterm Infants ◽  
Sensitivity And Specificity ◽  
Continuous Glucose Monitoring ◽  
Meta Analysis ◽  
Glucose Monitoring ◽  
Glucose Testing ◽  
Logistic Mixed Effects Model

Background and objectivesContinuous glucose monitoring (CGM) could be a valuable instrument for measurement of glucose concentration in preterm neonate. We undertook a systematic review and meta-analysis to compare the diagnostic accuracy of CGM devices to intermittent blood glucose evaluation methods for the detection of hypoglycaemic or hypoglycaemic events in preterm infants.Data sourcesA structured electronic database search was performed for studies that assessed the accuracy of CGM against any intermittent blood glucose testing methods in detecting episodes of altered glycaemia in preterm infants. No restrictions were used. Three review authors screened records and included studies.Data extractionRisk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. From individual patient data (IPD), sensitivity and specificity were determined using predefined thresholds. The mean absolute relative difference (MARD) of the studied CGM devices was assessed and if those satisfied the accuracy requirements (EN ISO 15197). IPD datasets were meta-analysed using a logistic mixed-effects model. A bivariate model was used to estimate the summary receiver operating characteristic curve (ROC) curve and extract the area under the curve (AUC). The overall level of certainty of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation.ResultsAmong 4481 records, 11 were included. IPD datasets were obtained for five studies. Only two of the studies showed an MARD lower than 10%, with none of the five CGM devices studied satisfying the European Union (EU) ISO 15197 requirements. Pooled sensitivity and specificity of CGM devices for hypoglycaemia were 0.39 and 0.99, whereas for hyperglycaemia were 0.87 and 0.99, respectively. The AUC was 0.70 and 0.86, respectively. The certainty of the evidence was considered as low to moderate. Limitations primarily related to the lack of representative population, reference standard and CGM device.ConclusionsCGM devices demonstrated low sensitivity for detecting hypoglycaemia in preterm infants, however, provided high accuracy for detection of hyperglycaemia.PROSPERO registration numberCRD42020152248.

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.

scholarly journals Effects of starvation and short-term refeeding on gastric emptying and postprandial blood glucose regulation in adolescent girls with anorexia nervosa

2018 ◽  
Vol 315 (4) ◽  
pp. E565-E573 ◽  
Author(s):  
Gabriella A. Heruc ◽  
Tanya J. Little ◽  
Michael R. Kohn ◽  
Sloane Madden ◽  
Simon D. Clarke ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Blood Glucose ◽  
Gastric Emptying ◽  
Glucose Monitoring ◽  
Postprandial Glucose ◽  
Glucose Absorption ◽  
Postprandial Blood Glucose ◽  
Future Research ◽  
C Peptide ◽  
Medical Risk

Postprandial glucose is reduced in malnourished patients with anorexia nervosa (AN), but the mechanisms and duration for this remain unclear. We examined blood glucose, gastric emptying, and glucoregulatory hormone changes in malnourished patients with AN and during 2 wk of acute refeeding compared with healthy controls (HCs). Twenty-two female adolescents with AN and 17 age-matched female HCs were assessed after a 4-h fast. Patients were commenced on a refeeding protocol of 2,400 kcal/day. Gastric emptying (13C-octanoate breath test), glucose absorption (3-O-methylglucose), blood glucose, plasma glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), insulin, C-peptide, and glucagon responses to a mixed-nutrient test meal were measured on admission and 1 and 2 wk after refeeding. HCs were assessed once. On admission, patients had slower gastric emptying, lower postprandial glucose and insulin, and higher glucagon and GLP-1 than HCs ( P < 0.05). In patients with AN, the rise in glucose (0–30 min) correlated with gastric emptying ( P < 0.05). With refeeding, postprandial glucose and 3-O-methylglucose were higher, gastric emptying faster, and baseline insulin and C-peptide less ( P < 0.05), compared with admission. After 2 wk of refeeding, postprandial glucose remained lower, and glucagon and GLP-1 higher, in patients with AN than HCs ( P < 0.05) without differences in gastric emptying, baseline glucagon, or postprandial insulin. Delayed gastric emptying may underlie reduced postprandial glucose in starved patients with AN; however, postprandial glucose and glucoregulatory hormone changes persist after 2 wk of refeeding despite improved gastric emptying. Future research should explore whether reduced postprandial glucose in AN is related to medical risk by examining associated symptoms alongside continuous glucose monitoring during refeeding.

scholarly journals Continuous glucose monitoring in obese pregnant women with no hyperglycemia on glucose tolerance test

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253047
Author(s):  
Rosa Maria Rahmi ◽  
Priscila de Oliveira ◽  
Luciano Selistre ◽  
Paulo Cury Rezende ◽  
Gabriela Neuvald Pezzella ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Continuous Glucose Monitoring ◽  
Glucose Tolerance Test ◽  
Glucose Monitoring ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels

Objective The objective of the present study was to compare 24-hour glycemic levels between obese pregnant women with normal glucose tolerance and non-obese pregnant women. Methods In the present observational, longitudinal study, continuous glucose monitoring was performed in obese pregnant women with normal oral glucose tolerance test with 75 g of glucose between the 24th and the 28th gestational weeks. The control group (CG) consisted of pregnant women with normal weight who were selected by matching the maternal age and parity with the same characteristics of the obese group (OG). Glucose measurements were obtained during 72 hours. Results Both the groups were balanced in terms of baseline characteristics (age: 33.5 [28.7–36.0] vs. 32.0 [26.0–34.5] years, p = 0.5 and length of pregnancy: 25.0 [24.0–25.0] vs. 25.5 [24.0–28.0] weeks, p = 0.6 in the CG and in the OG, respectively). Pre-breakfast glycemic levels were 77.77 ± 10.55 mg/dL in the CG and 82.02 ± 11.06 mg/dL in the OG (p<0.01). Glycemic levels at 2 hours after breakfast were 87.31 ± 13.10 mg/dL in the CG and 93.48 ± 18.74 mg/dL in the OG (p<0.001). Daytime blood glucose levels were 87.6 ± 15.4 vs. 93.1 ± 18.3 mg/dL (p<0.001) and nighttime blood glucose levels were 79.3 ± 15.8 vs. 84.7 ± 16.3 mg/dL (p<0.001) in the CG and in the OG, respectively. The 24-hour, daytime, and nighttime values of the area under the curve were higher in the OG when compared with the CG (85.1 ± 0.16 vs. 87.9 ± 0.12, 65.6 ± 0.14 vs. 67.5 ± 0.10, 19.5 ± 0.07 vs. 20.4 ± 0.05, respectively; p<0.001). Conclusion The results of the present study showed that obesity in pregnancy was associated with higher glycemic levels even in the presence of normal findings on glucose tolerance test.

scholarly journals Comparison of Efficacy and Safety of Lispro and Aspart Evaluated by Continuous Glucose Monitoring System in Patients with Newly Diagnosed Type 2 Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Bing-li Liu ◽  
Guo-ping Yin ◽  
Feng-fei Li ◽  
Yun Hu ◽  
Jin-dan Wu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Fasting Blood Glucose ◽  
Glucose Monitoring ◽  
Continuous Glucose Monitoring System ◽  
Newly Diagnosed ◽  
Glycemic Variations

Objective. To compare the effect of the rapid-acting insulin analogues (RAIAs) aspart (NovoRapid) and lispro (Prandilin) on glycemic variations by continuous glucose monitoring system (CGMS) in patients within newly diagnosed type 2 diabetes mellitus (T2DM) receiving continuous subcutaneous insulin infusion (CSII) and metformin intensive therapy. Methods. This is a single-blind randomized controlled trial. A total of 110 patients with newly diagnosed T2DM and with hemoglobin A1c (HbA1c%) above 9% was hospitalized and randomly divided into two groups: group Asp (NovoRapid group) and group Lis (Prandilin group). They all received CSII and metformin therapy. Treatments were maintained for 2-3 weeks after the glycaemic target was reached. C-peptide and insulin and fructosamine were determined. CGMS was continuously applied for 4 days after reaching the glycemic target. Results. There were no significant differences in daily dosages of insulin, fasting plasma C-P and 2 h postprandial C-P and insulin, and fructosamine at the baseline and endpoint between the groups Asp and Lis. No significant differences were seen in the 24 h mean amplitude of glycemic excursions (MAGE), 24 h mean blood glucose (MBG), the standard deviation of the MBG (SDBG), fasting blood glucose, number of glycemic excursion (NGE), and the incidence of hypoglycemia between the two groups. Similarly, no significant differences were found in areas under the curve (AUC) of glucose above 10.0 mmol/L or the decremental area over the curve (AOC) of glucose below 3.9 mmol/L between the two groups. Conclusions. Lispro and aspart had the similar ability to control the glycemic variations in patients with newly diagnosed T2DM. This study was registered with ClinicalTrials.gov, number ChiCTR-IPR-17010338.

Breakfast consumption modulates postprandial glycaemic, insulinaemic and NEFA response in pre-diabetic Asian males

2019 ◽  
Vol 123 (6) ◽  
pp. 664-672
Author(s):  
Elaine Wan Yi Peh ◽  
Katie Koecher ◽  
Ravi Menon ◽  
Christiani Jeyakumar Henry
Keyword(s):  
Blood Glucose ◽  
Dietary Intervention ◽  
Metabolic Diseases ◽  
Glucose Monitoring ◽  
Venous Catheter ◽  
Postprandial Glucose ◽  
Postprandial Blood Glucose ◽  
Adult Males ◽  
Breakfast Consumption ◽  
Peripheral Venous Catheter

AbstractBreakfast consumption is associated with a variety of nutritional and lifestyle-related health outcomes. The objective of the present study was to investigate how the consumption of breakfast affected blood glucose, insulin and NEFA profiles. A lower postprandial blood glucose, insulin and NEFA response is associated with a lower risk of development of metabolic diseases. In a randomised crossover non-blind design, thirteen pre-diabetic Chinese adult males (BMI 26·7 (sd 4·2) kg/m2) attended two sessions where they either consumed a high-glycaemic index breakfast or no breakfast consumption. Changes in glycaemic response over 27 h periods were measured using the Medtronic MiniMed iProTM2 continuous glucose monitoring system. Blood samples were collected using a peripheral venous catheter at fixed intervals for 3 h after the test meal and 3 h after standardised lunch consumption. Postprandial glucose, insulin and NEFA response was calculated as total AUC and incremental AUC using the trapezoidal rule that ignored the area under the baseline. It was found that breakfast consumption significantly decreased postprandial glucose, insulin and NEFA excursion response at lunch time (P = 0·001). Consumption of breakfast attenuated blood glucose profiles by minimising glycaemic excursions and reduced both insulinaemic and NEFA responses in pre-diabetic Asian males during the second meal. This simple dietary intervention may be a novel approach to help improve subsequent lunch glycaemic responses in Asians at high risk of developing diabetes.

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