Marcos Pazos-Couselo1, Jose Manuel García-López2, Maria González-Rodríguez2, Francisco Gude3, Jose Manuel Mayán-Santos4, Santiago Rodríguez-Segade5, Javier Rodríguez-García5, Felipe Casanueva6. 1. Hospital Complex Santiago de Compostela, Endocrinology and Nutrition Service, Santiago de Compostela, Spain. Electronic address: marcospazos@gmail.com. 2. Hospital Complex Santiago de Compostela, Endocrinology and Nutrition Service, Santiago de Compostela, Spain. 3. Hospital Complex Santiago de Compostela, Clinical Epidemiology Unit, Santiago de Compostela, Spain. 4. University of Santiago de Compostela, Gerontology Department, Santiago de Compostela, Spain. 5. University of Santiago de Compostela, Biochemistry and Molecular Biology, Santiago de Compostela, Spain. 6. Hospital Complex Santiago de Compostela, Endocrinology and Nutrition Service, Santiago de Compostela, Spain; Physiopathology of Obesity and Nutrition Biomedical Research Network Consortium, Santiago de Compostela, Spain.
Abstract
OBJECTIVES: Hypoglycemia is a limiting factor in the achievement of strict glycemic control. The primary objective of this 9-week study was to determine the frequency of hypoglycemia in patients with stable insulin-treated type 2 diabetes mellitus by comparing self-monitored blood glucose (SMBG) measurement with continuous glucose monitoring (CGM). METHODS: This was an observational prospective study. Included in the study were 63 stable, insulin-treated patients with type 2 diabetes. They were instructed to record 2 daily capillary blood glucose readings, pre- and/or postprandial, in a sequential way during 8 consecutive weeks. A CGM system was worn during an additional week. We evaluated the frequency of hypoglycemia using the 8-week SMBG profile and the 1 CGM week. RESULTS: SMBG revealed that 50% of the patients had experienced hypoglycemia. CGM found hypoglycemia in 59% of patients. Significantly higher percentages of hyperglycemic and hypoglycemic episodes were detected by CGM than by capillary blood glucose measurements (61.1% vs. 50.8%; p=0.047) and (3.8% vs. 1.7%; p=0.016); 33% of patients experienced nocturnal hypoglycemia, and 19% of patients who had no data concerning hypoglycemia recorded in the capillary blood glucose diary had experienced hypoglycemia as measured by CGM, and the hypoglycemia occurred mainly during the nocturnal period. CONCLUSIONS: In stable well-controlled, insulin-treated patients with type 2 diabetes, CGM showed higher numbers of hypoglycemic events than did SMBG, especially at night. CGM is a useful tool that provides clinically valuable information about glucose control in these patients.
OBJECTIVES:Hypoglycemia is a limiting factor in the achievement of strict glycemic control. The primary objective of this 9-week study was to determine the frequency of hypoglycemia in patients with stable insulin-treated type 2 diabetes mellitus by comparing self-monitored blood glucose (SMBG) measurement with continuous glucose monitoring (CGM). METHODS: This was an observational prospective study. Included in the study were 63 stable, insulin-treatedpatients with type 2 diabetes. They were instructed to record 2 daily capillary blood glucose readings, pre- and/or postprandial, in a sequential way during 8 consecutive weeks. A CGM system was worn during an additional week. We evaluated the frequency of hypoglycemia using the 8-week SMBG profile and the 1 CGM week. RESULTS:SMBG revealed that 50% of the patients had experienced hypoglycemia. CGM found hypoglycemia in 59% of patients. Significantly higher percentages of hyperglycemic and hypoglycemic episodes were detected by CGM than by capillary blood glucose measurements (61.1% vs. 50.8%; p=0.047) and (3.8% vs. 1.7%; p=0.016); 33% of patients experienced nocturnal hypoglycemia, and 19% of patients who had no data concerning hypoglycemia recorded in the capillary blood glucose diary had experienced hypoglycemia as measured by CGM, and the hypoglycemia occurred mainly during the nocturnal period. CONCLUSIONS: In stable well-controlled, insulin-treatedpatients with type 2 diabetes, CGM showed higher numbers of hypoglycemic events than did SMBG, especially at night. CGM is a useful tool that provides clinically valuable information about glucose control in these patients.
Keywords:
autosurveillance glycémique du diabète de type 2; continuous glucose monitoring; hypoglycemia; hypoglycémie; self-monitored blood glucose; surveillance du glucose en continue; type 2 diabetes
Authors: Robert R Henry; Poul Strange; Rong Zhou; Jeremy Pettus; Leon Shi; Sergey B Zhuplatov; Traci Mansfield; David Klein; Arie Katz Journal: Diabetes Technol Ther Date: 2018-09-14 Impact factor: 6.118