Literature DB >> 19905888

Improved quality of glycemic control and reduced glycemic variability with use of continuous glucose monitoring.

David Rodbard1, Timothy Bailey, Lois Jovanovic, Howard Zisser, Roy Kaplan, Satish K Garg.   

Abstract

OBJECTIVE: We evaluated effects of unmasking of continuous display of continuous glucose monitoring (CGM) on quality of glycemic control and glycemic variability.
METHODS: We reanalyzed CGM data from 85 patients using a 7-day glucose sensor. Glucose values were "masked" during the first week but "unmasked" during the next 2 weeks. We evaluated 48 criteria for quality of glycemic control, including mean glucose, SD, percentage of values within-, above- or below- specified ranges, Schlichtkrull's M(100) index, mean amplitude of glycemic excursion (MAGE), mean of daily differences (MODD), the J index, "Index of Glycemic Control" (IGC), Hyperglycemia Index, Hypoglycemia Index, High Blood Glucose Index (HBGI), Low Blood Glucose Index (LBGI), average daily risk range (ADRR), GRADE scores, and CONGA(n). We calculated SD values between daily means, between days-within time points, within days, between time points (for the average glucose profile for several days), and within series for time segments of arbitrary length.
RESULTS: Unmasking CGM displays resulted in rapid, highly statistically significant improvement in 29 indices, including percentage within, percentage above, and percentage below target range, mean glucose, SD, SD of daily means, MODD, M(100), IGC, GRADE, HBGI, and J index. Both hyperglycemia and hypoglycemia improved during the first week after unmasking; further improvement in hypoglycemia was seen during the following week. Results obtained using multiple criteria were consistent and highly correlated.
CONCLUSIONS: Continuous access to display of CGM sensors dramatically improved 29 indices of glycemic control and glycemic variability.

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Year:  2009        PMID: 19905888     DOI: 10.1089/dia.2009.0077

Source DB:  PubMed          Journal:  Diabetes Technol Ther        ISSN: 1520-9156            Impact factor:   6.118


  37 in total

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Journal:  Diabetes Technol Ther       Date:  2011-09-20       Impact factor: 6.118

Review 2.  The challenges of measuring glycemic variability.

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Review 4.  Average daily risk range as a measure for clinical research and routine care.

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5.  A semilogarithmic scale for glucose provides a balanced view of hyperglycemia and hypoglycemia.

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6.  GlyCulator: a glycemic variability calculation tool for continuous glucose monitoring data.

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Review 7.  Metrics Beyond Hemoglobin A1C in Diabetes Management: Time in Range, Hypoglycemia, and Other Parameters.

Authors:  Lorena Alarcon-Casas Wright; Irl B Hirsch
Journal:  Diabetes Technol Ther       Date:  2017-05       Impact factor: 6.118

8.  Evaluating quality of glycemic control: graphical displays of hypo- and hyperglycemia, time in target range, and mean glucose.

Authors:  David Rodbard
Journal:  J Diabetes Sci Technol       Date:  2014-10-14

9.  A Review of Continuous Glucose Monitoring-Based Composite Metrics for Glycemic Control.

Authors:  Michelle Nguyen; Julia Han; Elias K Spanakis; Boris P Kovatchev; David C Klonoff
Journal:  Diabetes Technol Ther       Date:  2020-03-04       Impact factor: 6.118

10.  Hypoglycemia in Type 2 Diabetes--More Common Than You Think: A Continuous Glucose Monitoring Study.

Authors:  Richa Redhu Gehlaut; Godwin Y Dogbey; Frank L Schwartz; Cynthia R Marling; Jay H Shubrook
Journal:  J Diabetes Sci Technol       Date:  2015-04-27
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