SOICHI Takeishi, Japan
Inuyama Chuo General Hospital diabetesPresenter of 3 Presentations
COMPARISON OF GLYCEMIC VARIABILITY METRIC VALUES CALCULATED FROM SENSOR GLUCOSE LEVELS MEASURED EVERY 5 AND 15 MINUTES USING CONTINUOUS GLUCOSE MONITOR DATA
Abstract
Background and Aims
Measurement frequency of continuous glucose monitor (CGM) may affect accuracy of glycemic variability (GV) metric values. We compared GV calculated from sensor glucose levels (SG) measured every 5 and 15 min.
Methods
We cross-sectionally investigated CGM (iPro2) data in 110 patients with type 2 diabetes whose 24-h SG was measured continuously during hospitalization for type 2 diabetes treatment. Mean glucose level, standard deviation (SD), coefficient of variation (CV), percentage of time in target range (70–180 mg/dL) [TIR 70–180], mean absolute glucose (MAG), glycemic variability percentage (GVP), low blood glucose index and high blood glucose index were calculated as GV. GV calculated from SG measured every 5 min in iPro2 and GV calculated from SG extracted every 15 min in iPro2 were compared.
Results
GV calculated from SG measured every 5 min and GV calculated from SG extracted every 15 min were almost equal numerically in all the GVs evaluated in this study. However, GV calculated from SG extracted every 15 min was statistically significantly higher than that calculated from SG measured every 5 min in SD and CV. Also, GV calculated from SG extracted every 15 min was statistically significantly lower than that calculated from SG measured every 5 min in MAG and GVP (Table).
Conclusions
GV calculated from SG measured every 5 min and GV calculated from SG extracted every 15 min were almost equal numerically in all GVs evaluated in this study.
DETAILED EVALUATION OF THE RELATIONSHIP BETWEEN INTERMEDIATE-TERM GLYCEMIC VARIABILITY AND HYPOGLYCEMIA USING CONTINUOUS GLUCOSE MONITOR DATA
Abstract
Background and Aims
The relationship between intermediate-term glycemic variability and hypoglycemia is well unknown, therefore, we analyzed that relationship using continuous glucose monitor (CGM) data.
Methods
We cross-sectionally analyzed CGM (FreeStyle Libre Pro) data for 97 patients with type 2 diabetes whose 24 h glucose levels were measured continuously for 13 days during hospitalization for type 2 diabetes treatment. Values over a span of 13 days for all glycemic variability and hypoglycemia metrics were evaluated. We have proposed novel glycemic variability metrics as follows: mean of daily difference 1 (MODD1) ÷ mean glucose level × 100 (MODD1/mean), mean absolute glucose (MAG) ÷ mean glucose level × 100 (MAG/mean), and glycemic variability percentage (GVP) ÷ mean glucose level × 100 (GVP/mean).
Results
The standard deviation (SD), MODD1, MAG, GVP, and the mean glucose level significantly negatively correlated with the percentage of time in the hypoglycemic range (< 70 mg/dL) [TIR < 70] (r = -0.32 – -0.75, p = 0.002 ~ < 0.001). Coefficient of variation (CV) tended to correlate with TIR < 70 positively. MODD1/mean, MAG/mean, and GVP/mean significantly positively correlated with TIR < 70. CV, MODD1/mean, MAG/mean, and GVP/mean significantly positively correlated with the percentage of time in the hypoglycemic range (< 54 mg/dL) [TIR < 54] (Table).
Conclusions
Intermediate-term glycemic variability which is divided by the mean glucose level may predict hypoglycemia.
COMPARISON OF EFFECTS WHEN SWITCHING LONG-ACTING INSULIN: RANDOMISED CROSSOVER STUDY
Abstract
Background and Aims
We investigated glycaemic variability from one day before to 6 days after switching in patients treated with long-acting insulin.
Methods
This study was conducted during hospitalization. 20 type 2 diabetic patients on basal insulin therapy were randomly allocated to two groups. In Group1, fasting blood glucose level was stabilized (not exceeding 180 mg/dL) using insulin glargine 300 U/mL (Glargine300); Glargine300 was continued for 6 days with the same dose; a continuous glucose monitoring device (FreeStyle Libre Pro) was worn on the fifth day of Glargine300 administration of the same dose (=attaching day:Day1); next, Glargine300 was switched to insulin degludec (Degludec) on Day3 with the same dose, and then Degludec was continued for 6 days with the same dose; Degludec was then switched to Glargine300 on Day9 with the same dose, and then Glargine300 was continued for 6 days with the same dose. Long-acting insulin was injected at 08:00. Test meals were given. In Group2, patients were administered in the order of Degludec, Glargine300, and Degludec, following the same regimen as Group1. Evaluation duration was from 24-h before to 144-h after switching.
Results
Mean of daily difference (MODD) between day2 and day3 (switch day:day1) was significantly lower in patients who switched from Glargine300 to Degludec (pGtoD) than in patients who switched from Degludec to Glargine300 (pDtoG). The others endpoints weren’t significantly different between pGtoD and pDtoG (table).
Conclusions
Day-to-day glycaemic variability between day2 and day3 was lower in pGtoD than in pDtoG.