Nocturnal hypoglycemia constitutes nearly one-third of hypoglycemic events in people with T1D. Strict glycemic control and great fluctuation of glucose are potential contributory factors. Daily SMBG profiles and the BGn model could help assess the risk of nocturnal hypoglycemia in T1D, which may support further development of preventive strategies (Diabetes Therapy)
Diabetes News
Category: Monitoring
Time spent outside of target glucose range for young children with type 1 diabetes: a continuous glucose monitor study
On average, participants spent the majority (13 h) of the day in hyperglycaemia (>10.0 mmol/l) and a median of ~1 h/day in hypoglycaemia (<3.9 mmol/l). Participants with minority race/ethnicity and higher parent education levels spent more time in target range, 3.9–10.0 mmol/l, and less time in hyperglycaemia (Diabetic Medicine)
Self-Monitoring of Blood Glucose Requirements with the Use of Intermittently Scanned Continuous Glucose Monitoring
These findings have important implications for cost-effectiveness and for decision-making around insulin dose calculations and driving. Our findings emphasize the need for continued SMBG testing among people at high risk of hypoglycemia who use isCGM. Cost-effectiveness analyses for isCGM may require revision (Diabetes Technology and Therapeutics)
Potential biomarkers for early detection of diabetic kidney disease
In DKD patients the galectin-3 and GDF-15 levels were inversely related to the eGFR which was further confirmed by the ROC curve demonstrating the potential of galectin-3 and GDF-15 as a biomarker (Diabetes Research and Clinical Practice)
The Relationship between Self‐Monitored Blood Glucose Values and Glycated haemoglobin in Insulin‐treated Patients with Type 2 Diabetes
These data provide patients and clinicians information on the relationship between HbA1c and SMBG measurements in patients with type 2 DM, and support the value of frequent blood glucose measurements for assessing overall glycaemic control (Diabetic Medicine)
Quality of Life and Glucose Control After 1 Year of Nationwide Reimbursement of Intermittently Scanned Continuous Glucose Monitoring in Adults Living With Type 1 Diabetes (FUTURE): A Prospective Observational Real-World Cohort Study
Nationwide unrestricted reimbursement of isCGM in people with type 1 diabetes treated in specialist diabetes centers results in higher treatment satisfaction, less severe hypoglycemia, and less work absenteeism, while maintaining quality of life and HbA1c (Diabetes Care)
Continuous Glucose Monitoring in People With Type 1 Diabetes on Multiple-Dose Injection Therapy: The Relationship Between Glycemic Control and Hypoglycemia
Use of rtCGM can flatten and attenuate the relationship between overall glucose control and hypoglycemia, exerting its greatest impact at lower values of HbA1c and mean glucose in people with type 1 diabetes using MDI regimens and at highest risk of hypoglycemia (Diabetes Care)
Effect of mean HbA1c on the association of HbA1c variability and all‐cause mortality in patients with type 2 diabetes mellitus
Mean HbA1c contributed to the correlation between HbA1c variability and all‐cause mortality. The risks associated with HbA1c variability and glycemic control status were similar. The relationship between mean HbA1c and mortality presented a J‐shaped distribution for both low and high HbA1c variability (Diabetes, Obesity and Metabolism)
Three European Retrospective Real-World Chart Review Studies to Determine the Effectiveness of Flash Glucose Monitoring on HbA1c in Adults with Type 2 Diabetes
Three European real-world, chart review studies in people with type 2 diabetes managed using basal bolus insulin therapy each concluded that HbA1c was significantly reduced after changing to use of flash glucose monitoring for 3–6 months in a real-world setting (Diabetes Therapy)
A review of the NG17 recommendations for the use of basal insulin in type 1 diabetes
Many of the trials used in this analysis were treat‐to‐target, which minimize differences in HbA1c. In the NMAs, statistical significance was severely undermined by the wide credible intervals. Despite these limitations, point estimates of HbA1c were used to rank the insulins and formed the basis of NG17 guidance. This study queries whether such analyses should be used to make specific clinical recommendations (Diabetic Medicine)
Appropriateness of action prompts for hypoglycaemia and hyperglycaemia in type 2 diabetes self‐management apps
Less than one‐fifth of apps provided evidence‐based steps to guide patients through hypo‐ and hyperglycaemia. The majority of apps failed to provide just‐in‐time diabetes self‐management education to prevent frequent or severe episodes of hypo‐ and hyperglycaemia (Diabetes/Metabolism Research and Reviews)
Vertebral Fractures in Individuals With Type 2 Diabetes: More Than Skeletal Complications Alone
Based on our findings, individuals with T2D should be systematically assessed for presence of VFs, and, as in individuals without T2D, their presence constitutes an indication to start osteoporosis treatment for the prevention of future fractures (Diabetes Care)
Fasting C‐peptide, a biomarker for hypoglycaemia risk in insulin‐naïve people with type 2 diabetes initiating basal insulin glargine 100 U/mL
FCP levels identified T2DM people experiencing different responses to basal insulin Gla‐100. A low FCP identifies a markedly insulin‐deficient, insulin‐sensitive subgroup/phenotype with an enhanced risk of hypoglycaemia, which requires a low initial basal insulin dose, cautious titration and earlier addition of prandial glucose‐lowering therapy (Diabetes, Obesity and Metabolism)
Glycemic Outcomes in Adults With T1D Are Impacted More by Continuous Glucose Monitoring Than by Insulin Delivery Method: 3 Years of Follow-Up From the COMISAIR Study
rtCGM was superior to SMBG in reducing A1C, hypoglycemia, and other end points in individuals with T1D regardless of their insulin delivery method. rtCGM+MDI can be considered an equivalent but lower-cost alternative to sensor-augmented insulin pump therapy and superior to treatment with SMBG+MDI or SMBG+CSII therapy (Diabetes Care)
Patient Perceptions of Diabetes Guideline Frameworks for Individualizing Glycemic Targets
Many older adults do not place high importance on factors recommended by guidelines to individualize diabetes treatment, especially when deciding to stop use of diabetes medications (JAMA)
Visceral adiposity index outperforms common anthropometric indices in predicting 10‐year diabetes risk: Results from the ATTICA study
The present findings suggest that VAI may be a useful index for predicting long‐term diabetes development and may exhibit better predictive ability to commonly used anthropometric indices (Diabetes/Metabolism Research and Reviews)
Controversies for Glucose Control Targets in Type 2 Diabetes: Exposing the Common Ground
The evidence suggests that glucose control takes 5 years or more to have any impact on vascular outcomes or mortality, so targets may also be higher in those with shorter life expectancy or higher health burden or simply reflect individual preferences. This article discusses the evidence behind these conclusions (Diabetes Care)
Diabetes Technology: Review of the 2019 American Diabetes Association Standards of Medical Care in Diabetes
This synopsis focuses on selected guidance relating to use of diabetes technology in adults with diabetes. Recommendations address self-monitoring of blood glucose, continuous glucose monitors, and automated insulin delivery systems (Annals of Internal Medicine)
Clinical Implications of Urinary C-Peptide Creatinine Ratio in Patients with Different Types of Diabetes
UCPCR is a practical and noninvasive marker that can distinguish between TIDM and T2DM or monogenic diabetes. reflects severe impaired beta cell function and the need for insulin or secretagogue therapy in T2DM patients (Journal of Diabetes Research)
Efficacy of two telemonitoring systems to improve glycaemic control during basal insulin initiation in patients with type 2 diabetes: The TeleDiab‐2 randomized controlled trial
Both telemonitoring systems improved glycaemic control to a similar extent, without increasing hypoglycaemic episodes (Diabetes, Obesity and Metabolism)
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