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Diabetes News Service

Diabetes News

Category: Monitoring

The impact of hyperglycemia on urinary albumin excretion in recent onset diabetes mellitus type II

Hyperglycemic state emerges as a powerful predictor of increased UAE even at the earliest stages of diabetes. The relative contribution of hypertension and macrovascular dysfunction to the development of microalbuminuria seems to be obscured by hyperglycemia, even in patients whose diabetes onset does not exceed a few months’ time(BMC Nephrology)

Risk of severe hypoglycaemia and its impact in type 2 diabetes in DEVOTE

The risk score demonstrated that a high risk of severe hypoglycaemia was associated with a high incidence of MACE and all‐cause mortality and that, in this high‐risk group, those treated with degludec had a lower incidence of MACE. These observations support the hypothesis that hypoglycaemia is a risk factor for cardiovascular events (Diabetes, Obesity and Metabolism)

Advances in glucose monitoring: Improving diabetes management through evidence-based medicine

After 50 years SMBG use remains equivocal. CGM, may face the same fate. While it has been reported that CGM use results in improved HbA 1c, the margin is small, and the studies scant. Like SMBG, CGM was introduced as “here’s something new, try it.” For CGM’s potential to be fully realized it must be understood that it can discover underlying metabolic perturbations that would otherwise go undetected (Primary Care Diabetes)

Value of Capillary Glucose Profiles in Assessing Risk of Nocturnal Hypoglycemia in Type 1 Diabetes Based on Continuous Glucose Monitoring

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)

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)

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)

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)

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