Jeremy Pettus1, Steven V Edelman2. 1. University of California, San Diego, San Diego, CA, USA. 2. University of California, San Diego, San Diego, CA, USA Veterans Affairs Medical Center, San Diego, CA, USA svedelman@vapop.ucsd.edu.
Abstract
OBJECTIVE: To understand differences between individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) in utilization of continuous glucose monitoring (CGM) data to adjust insulin therapy, either continuous subcutaneous insulin infusion (CSII) or multiple daily insulin injections (MDI). METHODS: We surveyed 300 individuals who regularly used real-time CGM, using 70 questions to obtain information about general CGM use and response to glucose rate of change (ROC) arrows. RESULTS: The survey was completed by 222 T1D and 78 T2D respondents treated with intensive insulin therapy. T1D respondents included CSII (n = 166) and MDI (n = 56) users. T2D respondents were more balanced: 34 (44%) versus 44 (56%), respectively. A larger percentage of T1D then T2D respondents reported a constant use of CGM (85% vs 61%, P < .001). T1D and T2D respondents reported similar substantial increases in correction dosages in response to rapidly increasing glucose (>3 mg/dL/min; 2 arrows up): +140% versus +136%, P = .4534. However, T1D respondents reported making smaller correction dosage reductions than T2D respondents in response to rapidly decreasing glucose (-42% vs -80%, P < .001). Differences between T1D and T2D respondents were also observed in mealtime dosage adjustments in response to rapidly increasing glucose compared to when glucose is stable (flat arrow) at 110 mg/dl: +81% versus +108%, respectively (P = .003). Although these adjustments are statistically different, both are large. CONCLUSIONS: CGM users often rely on ROC information when determining insulin doses and tend to be more aggressive in their insulin adjustments despite differences in type of diabetes.
OBJECTIVE: To understand differences between individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) in utilization of continuous glucose monitoring (CGM) data to adjust insulin therapy, either continuous subcutaneous insulin infusion (CSII) or multiple daily insulin injections (MDI). METHODS: We surveyed 300 individuals who regularly used real-time CGM, using 70 questions to obtain information about general CGM use and response to glucose rate of change (ROC) arrows. RESULTS: The survey was completed by 222 T1D and 78 T2D respondents treated with intensive insulin therapy. T1D respondents included CSII (n = 166) and MDI (n = 56) users. T2D respondents were more balanced: 34 (44%) versus 44 (56%), respectively. A larger percentage of T1D then T2D respondents reported a constant use of CGM (85% vs 61%, P < .001). T1D and T2D respondents reported similar substantial increases in correction dosages in response to rapidly increasing glucose (>3 mg/dL/min; 2 arrows up): +140% versus +136%, P = .4534. However, T1D respondents reported making smaller correction dosage reductions than T2D respondents in response to rapidly decreasing glucose (-42% vs -80%, P < .001). Differences between T1D and T2D respondents were also observed in mealtime dosage adjustments in response to rapidly increasing glucose compared to when glucose is stable (flat arrow) at 110 mg/dl: +81% versus +108%, respectively (P = .003). Although these adjustments are statistically different, both are large. CONCLUSIONS:CGM users often rely on ROC information when determining insulin doses and tend to be more aggressive in their insulin adjustments despite differences in type of diabetes.
Authors: Thomas C Blevins; Bruce W Bode; Satish K Garg; George Grunberger; Irl B Hirsch; Lois Jovanovič; Elizabeth Nardacci; Eric A Orzeck; Victor L Roberts; William V Tamborlane; Caitlin Rothermel Journal: Endocr Pract Date: 2010 Sep-Oct Impact factor: 3.443
Authors: Richard M Bergenstal; William V Tamborlane; Andrew Ahmann; John B Buse; George Dailey; Stephen N Davis; Carol Joyce; Tim Peoples; Bruce A Perkins; John B Welsh; Steven M Willi; Michael A Wood Journal: N Engl J Med Date: 2010-06-29 Impact factor: 91.245
Authors: William V Tamborlane; Roy W Beck; Bruce W Bode; Bruce Buckingham; H Peter Chase; Robert Clemons; Rosanna Fiallo-Scharer; Larry A Fox; Lisa K Gilliam; Irl B Hirsch; Elbert S Huang; Craig Kollman; Aaron J Kowalski; Lori Laffel; Jean M Lawrence; Joyce Lee; Nelly Mauras; Michael O'Grady; Katrina J Ruedy; Michael Tansey; Eva Tsalikian; Stuart Weinzimer; Darrell M Wilson; Howard Wolpert; Tim Wysocki; Dongyuan Xing Journal: N Engl J Med Date: 2008-09-08 Impact factor: 91.245
Authors: John R Petrie; Anne L Peters; Richard M Bergenstal; Reinhard W Holl; G Alexander Fleming; Lutz Heinemann Journal: Diabetologia Date: 2017-10-25 Impact factor: 10.122
Authors: Jordan E Pinsker; Mei Mei Church; Sue A Brown; Mary K Voelmle; Bruce W Bode; Brooke Narron; Lauren M Huyett; Joon Bok Lee; Jason O'Connor; Eric Benjamin; Bonnie Dumais; Trang T Ly Journal: Diabetes Technol Ther Date: 2021-09-03 Impact factor: 6.118
Authors: Nancy Elbarbary; Othmar Moser; Saif Al Yaarubi; Hussain Alsaffar; Adnan Al Shaikh; Ramzi A Ajjan; Asma Deeb Journal: Diab Vasc Dis Res Date: 2021 Nov-Dec Impact factor: 3.291