Compared with POC, FreeStyle Libre CGM showed lower mean daily glucose and higher detection of hypoglycemic events, particularly nocturnal and prolonged hypoglycemia in hospitalized patients with T2D. CGM’s accuracy was lower in the hypoglycemic range (Diabetes Care)
Diabetes News
Category: Monitoring
The Association Between HbA1c and Time in Hypoglycemia During CGM and Self-Monitoring of Blood Glucose in People With Type 1 Diabetes and Multiple Daily Insulin Injections
CGM is associated with considerably less time in hypoglycemia than SMBG at a broad range of HbA1c levels and is crucial for patients with MDI treatment if they are to have a chance to approach hypoglycemia targets (Diabetes Care)
Effect of Continuous Glucose Monitoring on Hypoglycemia in Older Adults With Type 1 Diabetes
Among adults aged 60 years or older with type 1 diabetes, continuous glucose monitoring compared with standard blood glucose monitoring resulted in a small but statistically significant improvement in hypoglycemia over 6 months (JAMA)
Effect of Continuous Glucose Monitoring on Glycemic Control in Adolescents and Young Adults With Type 1 Diabetes
Among adolescents and young adults with type 1 diabetes, continuous glucose monitoring compared with standard blood glucose monitoring resulted in a small but statistically significant improvement in glycemic control over 26 weeks (JAMA)
Efficacy of Intermittently Scanned Continuous Glucose Monitoring in the Prevention of Recurrent Severe Hypoglycemia
Although isCGM is safe, it does not appear to have a role in preventing recurrent severe hypoglycemia in at-risk individuals with diabetes (Diabetes Technology and Therapeutics)
Glucose Monitoring in Patients with Diabetes
isCGM may lead to improvements in HbA1c in certain subgroups of patients. Additional benefit with isCGM on time in glycemic range, glycemic variability, and hypoglycemia is unclear at this time (Diabetes Technology and Therapeutics)
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)
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)
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