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Rama Chandran S, Rahman N, Gandhi M, Tan NC, Phoon IKY, Seah DEJ, Cheah MH, Sek K, Gardner DSL. Intermittently scanned continuous glucose monitoring provides no benefit over structured self-monitoring of blood glucose in type 2 diabetes not on prandial insulin, in the context of diabetes self-management education: GLucose monitoring programme SingaporE (GLiMPSE). Diabetes Res Clin Pract 2024; 211:111678. [PMID: 38642860 DOI: 10.1016/j.diabres.2024.111678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE We evaluated the impact of intermittently scanned continuous glucose monitoring(is-CGM)over self-monitoring of blood glucose(SMBG) in the context of diabetes self-management education (DSME) in sub-optimally controlled type 2 diabetes(T2D) in a multi-ethnicsetting. RESEARCH DESIGN AND METHOD Randomized-controlled, open-label trial (NCT04564911), of T2D with HbA1c ≥ 7.5-≤10 %, on oral agents with/without basal insulin was carried out. Intervention arm received 6 weeks(w) continuous is-CGM, followed by one is-CGM/month till 24w. Control arm was advised to perform 4 SMBG/day. Educationwas delivered at weeks 0, 2, 8, 16. PRIMARY OUTCOME Change in HbA1c from baseline at 24w. Modified intention-to-treat (mITT) analysis with linear mixed-effect model for repeated measurementswas performed. RESULTS 176 subjects, age 55 ± 10.7 years(y), DM duration 11 ± 7.3y, BMI 27.8 ± 5.9 kg/m2, 58 % Male, 29.5 % basal insulin users were analysed. Within each arm,from baseline to 24w, mean HbA1c decreasedby -0.6 % (-6.6.mmol/mol, p-value < 0.01)and weight decreased(isCGM: -1.44 kg; SMBG: -1.25 kg, both p < 0.01). These changes were sustained to one year. However, there wasno significant difference in these parameters between arms (p-value > 0.05). CONCLUSION In the context of DSME, use of either SMBG or is-CGM led to improved glycaemia and reduced weight over a period of 24 weeks, sustained to one year.
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Affiliation(s)
- Suresh Rama Chandran
- Department of Endocrinology, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Nabilah Rahman
- Singapore Clinical Research Institute, Biostatistics, Singapore; National University of Singapore and National University Health System, Saw Swee Hock School of Public Health, Singapore
| | - Mihir Gandhi
- Duke-NUS Medical School, Singapore; Singapore Clinical Research Institute, Biostatistics, Singapore
| | | | | | | | | | - Kathleen Sek
- Department of Endocrinology, National University Health System, Singapore
| | - Daphne Su-Lyn Gardner
- Department of Endocrinology, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore.
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Kong L, Deng B, Guo M, Chen M, Wang X, Zhang M, Tang H, Wang Q, Yang L, Xiong Z. A systematic bibliometric analysis on the clinical practice of CGM in diabetes mellitus from 2012 to 2022. Front Endocrinol (Lausanne) 2023; 14:1229494. [PMID: 37810892 PMCID: PMC10556737 DOI: 10.3389/fendo.2023.1229494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Background Continuous glucose monitoring (CGM) has revolutionized diabetes management, but a comprehensive analysis of its clinical implementation is lacking. This study aims to explore CGM in diabetes practice over the past decade using bibliometric analysis. It will identify trends, research focal points, and provide a framework for future investigations. Materials and methods The Web of Science Core Collection (WOSCC) was utilized to acquire literature pertaining to the employment of continuous glucose monitoring (CGM) in diabetes that was published between the years 2012 and 2022, and to conduct a comprehensive analysis of the associated citation data. To achieve bibliometric visualization and analysis of the collated data, the bibliography package in the Rstudio(v.4.2.2), Citespace 6.2.R4, and VOS viewer were employed. Results A total of 3024 eligible publications were extracted from 91 countries, with the United States being the leading country in terms of the number of issued articles. Furthermore, the annual publication rate has shown a gradual increase during the past decade. Among the various journals in this field, DIABETES TECHNOLOGY & THERAPEUTICS was identified as the most highly cited one. Keyword clustering analysis of the extracted publications indicates that the research hotspots in the past decade have primarily focused on "continuous glucose monitoring", "glycemic variability", "type 1 diabetes", "hypoglycemia", and "glycemic control". Moreover, the analysis of keyword emergence reveals that "Time In Range" and "Young Adult" represent the current research frontiers for the years 2012-2022. Conclusion The concept of Time in Range (TIR) has garnered considerable attention as a significant area of inquiry and an emerging research trend in the clinical practice of Continuous Glucose Monitoring (CGM) for Diabetes Mellitus. Moreover, recent investigations have demonstrated a growing focus on young adults with type 1 diabetes as the research population of interest. In the foreseeable future, research endeavors will persist in the pursuit of improving glycemic management among young adults through the utilization of continuous glucose monitoring (CGM) technology, while also delving into the examination of the Time in Range metric via supplementary clinical investigations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Liwei Yang
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Zhenzhen Xiong
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
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Xie X, Li C, Tiggelaar S, Simbulan F, Falk L, Brophy JM. Developing a cross-validation tool for evaluating economic evidence in rapid literature reviews. J Comp Eff Res 2022; 11:1151-1160. [PMID: 36170031 DOI: 10.2217/cer-2021-0274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Rapid economic reviews efficiently summarize economic evidence. However, reporting main findings without assessing quality and credibility can be misleading. The objective of this study was to develop a rapid cross-validation screening tool to evaluate economic evidence when conducting rapid economic literature reviews. Methods: This article outlines our reasoning and the theoretical concepts for developing the screening tool. Results: This cross-validation tool is a qualitative approach under a Bayesian framework that uses prior health economic evidence to gauge the credibility of the rapid economic review's findings. This article describes an application of this tool and highlights practical considerations for its development and deployment. Conclusion: This tool can provide a valuable screening instrument to evaluate the quality and credibility of the economic evidence.
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Affiliation(s)
- Xuanqian Xie
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - Chunmei Li
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - Sean Tiggelaar
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - Frances Simbulan
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - Lindsey Falk
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - James M Brophy
- Departments of Medicine & Epidemiology, Biostatistics, & Occupational Health, McGill University, Montreal, QC H3A 0G4, Canada
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Nishimura E, Oka S, Ozawa J, Tanaka K, Momose T, Kabe K, Namba F. Safety and feasibility of a factory-calibrated continuous glucose monitoring system in term and near-term infants at risk of hypoglycemia. Turk Arch Pediatr 2021; 56:115-120. [PMID: 34286319 DOI: 10.5152/turkarchpediatr.2020.20183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/22/2020] [Indexed: 11/22/2022]
Abstract
Objective Hypoglycemia increases the risk of adverse neurological outcomes in neonates. Adequate glucose monitoring requires repetitive and painful blood sampling. We aimed to evaluate the feasibility and accuracy of a continuous glucose monitoring system (CGMS) using factory-calibrated sensors to improve glucose monitoring and decrease the frequency of blood samples in neonates. Material and Methods A methodological study was conducted to investigate a correlation of CGMS values with blood glucose measurements. Results Factory-calibrated CGMS sensors were placed on 21 infants at risk of hypoglycemia after delivery. CGMS values were compared with blood glucose concentrations. Thirty-seven pairs of CGMS and blood glucose values were obtained. There was a good correlation between CGMS and blood glucose values (R=0.67, p<0.01) with a mean difference (2 standard deviations) of 9.78 (-24.68 to 44.25) mg/dL. The mean differences at <3 hours and ≥3 hours after sensor placement were 17.35 (-4.54 to 39.21) mg/dL and 0.88 (-37.62 to 39.38) mg/dL, respectively. CGMS values were significantly higher than blood glucose concentration at <3 hours after sensor placement (p<0.01), whereas no significant differences in glucose values were observed between the CGMS and blood glucose values at ≥3 hours after sensor placement (p=0.852). Conclusion The factory-calibrated CGMS was a safe and feasible modality for glucose monitoring. However, it has a tendency to overestimate the blood glucose concentrations. Therefore, this system should be used cautiously for neonates at risk of hypoglycemia, especially within 3 hours after sensor placement.
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Affiliation(s)
- Eri Nishimura
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Shuntaro Oka
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Junichi Ozawa
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Kosuke Tanaka
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Taichi Momose
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Kazuhiko Kabe
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Fumihiko Namba
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Lin R, Brown F, James S, Jones J, Ekinci E. Continuous glucose monitoring: A review of the evidence in type 1 and 2 diabetes mellitus. Diabet Med 2021; 38:e14528. [PMID: 33496979 DOI: 10.1111/dme.14528] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/24/2020] [Accepted: 01/20/2021] [Indexed: 12/17/2022]
Abstract
CONTEXT AND AIM Continuous glucose monitoring (CGM) is becoming widely accepted as an adjunct to diabetes management. Compared to standard care, CGM can provide detailed information about glycaemic variability in an internationally standardised ambulatory glucose profile, enabling more informed user and clinician decision making. We aimed to review the evidence, user experience and cost-effectiveness of CGM. METHODS A literature search was conducted by combining subject headings 'CGM' and 'flash glucose monitoring', with key words 'type 1 diabetes' and 'type 2 diabetes', limited to '1999 to current'. Further evidence was obtained from relevant references of retrieved articles. RESULTS There is a strong evidence for CGM use in people with type 1 diabetes, with benefits of reduced glycated haemoglobin and hypoglycaemia, and increased time in range. While the evidence for CGM use in type 2 diabetes is less robust, similar benefits have been demonstrated. CGM can improve diabetes-related satisfaction in people with diabetes (PWD) and parents of children with diabetes, as well as the clinician experience. However, CGM does have limitations including cost, accuracy and perceived inconvenience. Cost-effectiveness analyses have indicated that CGM is a cost-effective adjunct to type 1 diabetes management that is associated with reduced diabetes-related complications and hospitalisation. CONCLUSIONS Continuous glucose monitoring is revolutionising diabetes management. It is a cost-effective adjunct to diabetes management that has the potential to improve glycaemic outcomes and quality of life in PWD, especially type 1 diabetes.
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MESH Headings
- Blood Glucose/analysis
- Blood Glucose Self-Monitoring/economics
- Blood Glucose Self-Monitoring/instrumentation
- Cost-Benefit Analysis/statistics & numerical data
- Diabetes Complications/epidemiology
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/economics
- Diabetes Mellitus, Type 1/epidemiology
- Diabetes Mellitus, Type 1/therapy
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/economics
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/therapy
- Glycated Hemoglobin/analysis
- Glycemic Control/economics
- Glycemic Control/instrumentation
- Glycemic Control/statistics & numerical data
- History, 20th Century
- History, 21st Century
- Hospitalization/statistics & numerical data
- Humans
- Patient Satisfaction/statistics & numerical data
- Quality of Life
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Affiliation(s)
- Rose Lin
- Department of Endocrinology, Austin Health, Heidelberg, Vic., Australia
- Department of Medicine, Austin Health, Heidelberg, Vic., Australia
| | - Fran Brown
- Melbourne Diabetes Education and Support, Heidelberg Heights, Vic., Australia
| | - Steven James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Petrie, Qld, Australia
| | - Jessica Jones
- Department of Medicine, Austin Health, Heidelberg, Vic., Australia
- Melbourne Medical School, University of Melbourne (Austin Campus), Melbourne, Vic., Australia
| | - Elif Ekinci
- Department of Endocrinology, Austin Health, Heidelberg, Vic., Australia
- Department of Medicine, Austin Health, Heidelberg, Vic., Australia
- Melbourne Medical School, University of Melbourne (Austin Campus), Melbourne, Vic., Australia
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Yin J, Han M, Li L, Li Y, Liu Z, Yang J, Liu Y. To Assess Liraglutide's Therapeutic Effect in Patients with Type 2 Diabetes Mellitus Using Flash Glucose Monitoring System. Diabetes Metab Syndr Obes 2021; 14:4399-4407. [PMID: 34744445 PMCID: PMC8565899 DOI: 10.2147/dmso.s331833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/15/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Liraglutide, a type of glucagon-like peptide-1 receptor agonist, has significant anti-hyperglycaemic activity without increasing the incidence of hypoglycaemia. In addition, it can improve β-cell function and insulin resistance. The flash glucose monitoring system (FGMS) is a novel method to document consecutive and detailed interstitial glucose levels, further reflecting blood glucose levels. This study aimed to investigate the therapeutic effect of liraglutide on blood glucose management (glucose variability, hyperglycaemia, and the incidence of hypoglycaemia), β-cell function, and insulin resistance in patients with diabetes. PATIENTS AND METHODS Thirty-three patients with type 2 diabetes mellitus were recruited in this study. On the basis of metformin monotherapy, these patients received liraglutide add-on treatment for 3 months. The FGMS was used to document glucose levels before and after add-on treatment. Parameters of glucose variability, blood glucose levels at specific time periods, and the incidence of hypoglycaemia were assessed according to FGMS data and compared before and after liraglutide add-on treatment. Further, β-cell function and insulin resistance were assessed and compared before and after liraglutide add-on treatment. RESULTS According to FGMS monitoring data, liraglutide add-on treatment significantly improved general, within-day, and day-to-day glucose variability and the glucose-target-rate. Further, the specifically analysed blood glucose levels at different time periods showed that blood glucose levels significantly decreased at nocturnal, fasting, and postprandial periods after add-on treatment. The incidence of hypoglycaemia was comparable during the whole day, daytime, and night-time according to the prespecified cutoffs (3.9 mmol/L and 3.0 mmol/L) before and after add-on treatment. Analysis of other assessed parameters revealed significant differences in glycosylated hemoglobin A1c and fasting blood glucose levels as well as parameters of β-cell function and insulin resistance before and after add-on treatment. CONCLUSION In type 2 diabetes mellitus, liraglutide treatment can effectively decrease glucose variability and ameliorate hyperglycaemia without increasing the incidence of hypoglycaemia. In addition, liraglutide can significantly improve the β-cell function and insulin resistance.
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Affiliation(s)
- Jianhong Yin
- Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Minmin Han
- Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Linhui Li
- Department of Endocrinology, Taiyuan Central Hospital, Taiyuan, Shanxi, People’s Republic of China
| | - Yang Li
- Department of Infectious Diseases, Linfen People’s Hospital, Linfen, Shanxi, People’s Republic of China
| | - Zi’ang Liu
- Third Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
- The Affiliated Bethune Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Jing Yang
- Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
- Correspondence: Jing Yang; Yunfeng Liu Department of Endocrinology, First Hospital of Shanxi Medical University, No. 85 Jiefang Nan Road, Yingze District, Taiyuan, Shanxi Province, People’s Republic of ChinaTel +86 18703416196Fax +86 351-4639758 Email ;
| | - Yunfeng Liu
- Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
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Zhou Y, Deng H, Liu H, Yang D, Xu W, Yao B, Yan J, Weng J. Effects of novel flash glucose monitoring system on glycaemic control in adult patients with type 1 diabetes mellitus: protocol of a multicentre randomised controlled trial. BMJ Open 2020; 10:e039400. [PMID: 33277281 PMCID: PMC7722373 DOI: 10.1136/bmjopen-2020-039400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Optimal glycaemic control is beneficial to prevent and delay microvascular complications in patients with type 1 diabetes mellitus (T1DM). The benefits of flash glucose monitoring (FGM) have been proved among well-controlled adults with T1DM, but evidence for FGM in adults with T1DM who have suboptimal glycaemic control is limited. This study aims to evaluate the effect of FGM in suboptimally controlled adult patients with T1DM . METHODS AND ANALYSIS This open-label, multicentre, randomised trial will be conducted at eight tertiary hospitals and recruit 104 adult participants (≥18 years old) with T1DM diagnosed for at least 1 year and with suboptimal glycaemic control (glycated haemoglobin (HbA1c) ranging from 7.0% to 10.0%). After a run-in period (baseline, 0-2 weeks), eligible participants will be randomised 1:1 to either use FGM or self-monitoring of blood glucose alone consequently for the next 24 weeks. At baseline, 12-14 weeks and 24-26 weeks, retrospective continuous glucose monitoring (CGM) systems will be used in both groups for device-related data collection. Biological metrics, including HbA1c, blood routine, lipid profiles, liver enzymes, questionnaires and adverse events, will be assessed at baseline, week 14 and week 26. All analyses will be conducted on the intent-to-treat population. Efficacy endpoint analyses will also be repeated on the per-protocol population. The primary outcome is the change of HbA1c from baseline to week 26. The secondary outcomes are the changes of CGM metrics, including time spent in range, time spent in target, time spent below range, time spent above range, SD, coefficient of variation, mean amplitude of glucose excursions, high or low blood glucose index, mean of daily differences, percentage of HbA1c in target (<7%), frequency of FGM use, total daily insulin dose and the scores of questionnaires including Diabetes Distress Scale, Hypoglycemia Fear Scale and European Quality of Life Scale. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University in January 2017. Ethical approval has been obtained at all centres. All participants will be provided with oral and written information about the trial. The study will be disseminated by peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER NCT03522870.
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Affiliation(s)
- Yongwen Zhou
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, China
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University;Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Hongrong Deng
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University;Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Hongxia Liu
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University;Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Daizhi Yang
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University;Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University;Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Bin Yao
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University;Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, Third Affiliated Hospital of Sun Yat-sen University;Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Jianping Weng
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, China
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Castellana M, Parisi C, Di Molfetta S, Di Gioia L, Natalicchio A, Perrini S, Cignarelli A, Laviola L, Giorgino F. Efficacy and safety of flash glucose monitoring in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis. BMJ Open Diabetes Res Care 2020; 8:8/1/e001092. [PMID: 32487593 PMCID: PMC7265013 DOI: 10.1136/bmjdrc-2019-001092] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 05/01/2020] [Accepted: 05/08/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Flash glucose monitoring (FGM) is a factory-calibrated sensor-based technology for the measurement of interstitial glucose. We performed a systematic review and meta-analysis to assess its efficacy and safety in patients with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS PubMed, CENTRAL, Scopus and Web of Science were searched in July 2019. Twelve studies with a follow-up longer than 8 weeks, evaluating 2173 patients on prandial insulin, multiple daily insulin injections or continuous subcutaneous insulin infusion were included. The following data were extracted: HbA1c, time in range, time above 180 mg/dL, time below 70 mg/dL, frequency of hypoglycemic events, number of self-monitoring of blood glucose (SMBG) measurements, total daily insulin dose, patient-reported outcomes, adverse events, and discontinuation rate. A comparison with SMBG was conducted. RESULTS FGM use was associated with a reduction in HbA1c (-0.26% (-3 mmol/mol); p=0.002) from baseline to the last available follow-up, which correlated with HbA1c levels at baseline (-0.4% (-4 mmol/mol) for each 1.0% (11 mmol/mol) of HbA1c above 7.2% (55 mmol/mol)). Also, a decrease in time below 70 mg/dL was found (-0.60 hours/day; p=0.04). Favorable findings in patient-reported outcomes and no device-related serious adverse events were reported. When compared with SMBG, FGM was characterized by no statistically different change in HbA1c (p=0.09), with lower number of SMBG measurements per day (-3.76 n/day; p<0.001) and risk of discontinuation (relative risk=0.42; p=0.001). A limited number of studies, with a heterogeneous design and usually with a short-term follow-up and without specific training, were found. CONCLUSIONS The present review provides evidence for the use of FGM as an effective strategy for the management of diabetes.
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Affiliation(s)
- Marco Castellana
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
| | - Claudia Parisi
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
| | - Sergio Di Molfetta
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
| | - Ludovico Di Gioia
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
| | - Annalisa Natalicchio
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
| | - Sebastio Perrini
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
| | - Angelo Cignarelli
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
| | - Luigi Laviola
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
| | - Francesco Giorgino
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Puglia, Italy
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Yamada M, Okada S, Oda H, Nakajima Y, C Bastie C, Kasai Y, Osaki A, Shimoda Y, Shibusawa R, Uehara R, Saito T, Ozawa A, Yamada E. Evaluation of the relationship between glycated hemoglobin A1c and mean glucose levels derived from the professional continuous flash glucose monitoring system. Endocr J 2020; 67:531-536. [PMID: 32023560 DOI: 10.1507/endocrj.ej19-0502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Previously, we reported that short-term continuous glucose monitoring (CGM) with the professional iPro2© CGM device is a good clinical indicator of glycated hemoglobin (HbA1c) levels. However, there was no significant correlation between CGM and HbA1c levels when HbA1c levels were >8.0%. To further investigate this issue, we performed a similar study using the FreeStyle Libre Pro©, a newer device that does not require glucose calibration and allows patients to be examined for up to 14 days. Fifty-nine patients (68% women, 32% men) were examined. Twenty-eight and 31 patients presented with type 1 and type 2 diabetes, respectively. Clinically assessed HbA1c levels were compared to blood glucose levels determined by the FreeStyle Libre Pro© for up to 14 days (10.7 ± 3.7 days). We found a significant correlation between HbA1c and CGM levels even when HbA1c levels were >8.0%. Additionally, the correlation between HbA1c and average glucose was identified with the modern CGM and was found to deviate substantially from the new suggested formula. More importantly, we found a more robust correlation between HbA1c and CGM levels in patients with type 2 diabetes. Overestimation or underestimation of blood glucose levels through CGM might increase the risks of inappropriate clinical treatment of diabetes patients. Our results indicate the need for proper CGM data interpretation individualized for each patient to better assist the determination of customized treatments for patients.
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Affiliation(s)
- Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Shuichi Okada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Hiroki Oda
- Faculty of Medicine, Gunma University School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Yasuyo Nakajima
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Claire C Bastie
- Division of Biomedical Sciences, Warwick Medical School, Coventry CV4 7AL, United Kingdom
| | - Yuko Kasai
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Aya Osaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Yoko Shimoda
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Ryo Shibusawa
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Ryota Uehara
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Tsugumichi Saito
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Atsushi Ozawa
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Eijiro Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
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10
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Noah NM, Ndangili PM. Current Trends of Nanobiosensors for Point-of-Care Diagnostics. JOURNAL OF ANALYTICAL METHODS IN CHEMISTRY 2019; 2019:2179718. [PMID: 31886019 PMCID: PMC6925704 DOI: 10.1155/2019/2179718] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/03/2019] [Accepted: 09/28/2019] [Indexed: 05/24/2023]
Abstract
In order to provide better-quality health care, it is very important that high standards of health care management are achieved by making timely decisions based on rapid diagnostics, smart data analysis, and informatics analysis. Point-of-care testing ensures fast detection of analytes near to the patients facilitating a better disease diagnosis, monitoring, and management. It also enables quick medical decisions since the diseases can be diagnosed at an early stage which leads to improved health outcomes for the patients enabling them to start early treatment. In the recent past, various potential point-of-care devices have been developed and they are paving the way to next-generation point-of-care testing. Biosensors are very critical components of point-of-care devices since they are directly responsible for the bioanalytical performance of an essay. As such, they have been explored for their prospective point-of-care applications necessary for personalized health care management since they usually estimate the levels of biological markers or any chemical reaction by producing signals mainly associated with the concentration of an analyte and hence can detect disease causing markers such as body fluids. Their high selectivity and sensitivity have allowed for early diagnosis and management of targeted diseases; hence, facilitating timely therapy decisions and combination with nanotechnology can improve assessment of the disease onset and its progression and help to plan for treatment of many diseases. In this review, we explore how nanotechnology has been utilized in the development of nanosensors and the current trends of these nanosensors for point-of-care diagnosis of various diseases.
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Affiliation(s)
- Naumih M. Noah
- School of Pharmacy and Health Sciences, United States International University-Africa, P.O. Box 14634-00800, Nairobi, Kenya
| | - Peter M. Ndangili
- Department of Chemical Science and Technology (DCST), Technical University of Kenya, P.O. Box 52428-00200, Nairobi, Kenya
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11
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Zimmerman C, Albanese-O'Neill A, Haller MJ. Advances in Type 1 Diabetes Technology Over the Last Decade. EUROPEAN ENDOCRINOLOGY 2019; 15:70-76. [PMID: 31616496 PMCID: PMC6785958 DOI: 10.17925/ee.2019.15.2.70] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/20/2019] [Indexed: 12/17/2022]
Abstract
The past 10 years have witnessed rapid advances in the technology used to treat patients with type 1 diabetes (T1D). While the disease burden is still high, these advances have contributed to improvements in both glycaemic control and quality of life for many of those affected. New technologies allow for individualisation of care, as patients are able to work with their providers to determine which systems best fit their lifestyle and needs. In addition, thanks to improved glucose monitoring technologies, patients can now simultaneously improve glycaemic control and reduce hypoglycaemia, thereby mitigating risk for acute and chronic complications. Technological advances in T1D care are rapidly moving us toward increasingly automated devices, which offer the promise of reduced disease burden. In this article, we review advances in glucose monitoring, insulin and glucagon delivery, and the applications and algorithms seeking to integrate novel technologies.
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12
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Al Hayek AA, Robert AA, Al Dawish MA. Differences of FreeStyle Libre Flash Glucose Monitoring System and Finger Pricks on Clinical Characteristics and Glucose Monitoring Satisfactions in Type 1 Diabetes Using Insulin Pump. CLINICAL MEDICINE INSIGHTS-ENDOCRINOLOGY AND DIABETES 2019; 12:1179551419861102. [PMID: 31308786 PMCID: PMC6604122 DOI: 10.1177/1179551419861102] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 06/07/2019] [Indexed: 12/15/2022]
Abstract
Background: To evaluate the different experience of freestyle libre and finger pricks on
clinical characteristics and glucose monitoring satisfaction (GMS) in
patients with type 1 diabetes (T1D) using insulin pump (IP). Methods: A prospective study was carried out on 47 (aged 17-21 years) T1D, who used
conventional finger-pricking method for self-testing the glucose. The
experiments were conducted between March 2018 and September 2018. For
carrying out the study, the flash glucose monitoring (FGM) sensors were
placed on each participant, at the baseline visit, by a trained diabetes
educator. Furthermore, to determine the total number of scans conducted
during the study period, the respective ambulatory glucose profiles were
generated by computing the data collected from the sensors. In addition, a
trained interviewer handed over the GMS questionnaire to each patient, at
the baseline and at 12 weeks of the study. Results: In comparison to the baseline (finger pricks), various parameters such as:
HbA1c (P = .042), hypoglycemia (P = .001),
mean capillary glucose (P = .004), total daily insulin dose
(P = .0001), percentage of bolus insulin
(P = .0001), daily bolus frequency
(P = .0001), and daily carbohydrates intake
(P = .0001) showed a significant improvement at
12 weeks. Similarly, substantial augmentation was noticed, in the sub
domains of GMS, that is, openness (P = .0001), emotional
burden (P = .0001), behavioral burden
(P = .0001), and trust (P = .0001) at
12 weeks as compared to baseline. Overall, total GMS score at baseline was
1.72 ± 0.37, which increased up to 3.41 ± 0.49 (P = .0001)
in the time period of 12 weeks. The HbA1c (r2 = 0.45),
hypoglycemia (r2 = 0.58), and the mean number of FGM scans,
exhibited a negative correlation, while GMS (r2 = 0.52) and the
mean number of FGM scans, exhibited a positive correlation. Conclusion: The frequency of hypoglycemia, HbA1c level, capillary glucose, daily
carbohydrates intake decreased, while the total daily insulin dose, daily
bolus insulin and total GMS score increased with the use of FGM scanning for
12 weeks.
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Affiliation(s)
- Ayman A Al Hayek
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Asirvatham A Robert
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohamed A Al Dawish
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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13
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Toward Long-Term Implantable Glucose Biosensors for Clinical Use. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9102158] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Continuous glucose monitoring (CGM) sensors have led a paradigm shift to painless, continuous, zero-finger pricking measurement in blood glucose monitoring. Recent electrochemical CGM sensors have reached two-week lifespans and no calibration with clinically acceptable accuracy. The system with the recent CGM sensors is identified as an “integrated glucose monitoring system,” which can replace finger-pricking glucose-testing for diabetes treatment decisions. Although such innovation has brought CGM technology closer to realizing the artificial pancreas, discomfort and infection problems have arisen from short lifespans and open wounds. A fully implantable sensor with a longer-term lifespan (90 days) is considered as an alternative CGM sensor with high comfort and low running cost. However, it still has barriers, including surgery for applying and replacing and frequent calibration. If technical refinement is conducted (e.g., stability and reproducibility of sensor fabrication), fully implantable, long-term CGM sensors can open the new era of continuous glucose monitoring.
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14
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Scharf J, Nguyen XQ, Vu-Eickmann P, Krichbaum M, Loerbroks A. Perceived Usefulness of Continuous Glucose Monitoring Devices at the Workplace: Secondary Analysis of Data From a Qualitative Study. J Diabetes Sci Technol 2019; 13:242-247. [PMID: 30027749 PMCID: PMC6399790 DOI: 10.1177/1932296818789143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous research suggests that psychosocial working conditions may detrimentally affect diabetes self-management behavior at work, including self-monitoring of glucose levels. We aimed to better understand the potential usefulness of continuous glucose monitoring devices at the workplace according to employees with diabetes. METHODS We carried out secondary analyses of data from a qualitative study, which sought to explore potential barriers to and solutions for effective diabetes self-management at work. Interviews were carried out in face-to-face contact or by telephone and were transcribed and content-analyzed using MaxQDA. The used topic guide did not specifically inquire after continuous glucose monitoring devices, but views on the suitability of those devices at the workplace repeatedly emerged from the interviews. Data from 25 employed adults with diabetes mellitus type 1 or type 2 on insulin therapy were included. RESULTS The major perceived improvements associated with the use of continuous glucose monitoring devices pertained to their time-saving application that allowed for an increased frequency of glucose level assessments and for socially covert glucose measurement. The socially less noticeable way of monitoring glucose level was specifically perceived as beneficial, as employees with diabetes believed their illness would thereby attract less attention. Fewer or shorter interruptions as well as the reliability of integrated alarm systems were perceived to increase concentration at work and workability. CONCLUSIONS Continuous glucose monitoring devices were perceived to facilitate glucose management at the workplace, which may exert positive effects on compliance as well as functioning at work. Further research would be of interest to statistically confirm our findings in occupational samples.
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MESH Headings
- Adult
- Biomarkers/blood
- Blood Glucose/drug effects
- Blood Glucose/metabolism
- Blood Glucose Self-Monitoring/instrumentation
- Blood Glucose Self-Monitoring/psychology
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/diagnosis
- Diabetes Mellitus, Type 1/drug therapy
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/psychology
- Female
- Health Knowledge, Attitudes, Practice
- Humans
- Hypoglycemic Agents/therapeutic use
- Insulin/therapeutic use
- Interviews as Topic
- Male
- Middle Aged
- Occupational Health
- Patient Compliance
- Predictive Value of Tests
- Qualitative Research
- Self Care
- Social Environment
- Workplace/psychology
- Young Adult
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Affiliation(s)
- Jessica Scharf
- Institute of Occupational, Social and Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Xuan Quynh Nguyen
- Institute of Occupational, Social and Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Patricia Vu-Eickmann
- Institute of Occupational, Social and Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Michael Krichbaum
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany
- Adrian Loerbroks, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr 1, 40225 Düsseldorf, Germany.
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Moonian O, Jodheea-Jutton A, Khedo KK, Baichoo S, Nagowah SD, Nagowah L, Mungloo-Dilmohamud Z, Cheerkoot-Jalim S. Recent advances in computational tools and resources for the self-management of type 2 diabetes. Inform Health Soc Care 2019; 45:77-95. [PMID: 30653364 DOI: 10.1080/17538157.2018.1559168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: While healthcare systems are investing resources on type 2 diabetes patients, self-management is becoming the new trend for these patients. Due to the pervasiveness of computing devices, a number of computerized systems are emerging to support the self-management of patients.Objective: The primary objective of this review is to identify and categorize the computational tools that exist for the self-management of type 2 diabetes, and to identify challenges that need to be addressed.Results: The tools have been categorized into web applications, mobile applications, games and ubiquitous diabetes management systems. We provide a detailed description of the salient features of each category along with a comparison of the various tools, listing their challenges and practical implications. A list of platforms that can be used to develop new tools for the self-management of type 2 diabetes, namely mobile applications development, sensor development, cloud computing, social media, and machine learning and predictive analysis platforms, are also provided.Discussions: This paper identifies a number of challenges in the existing categories of computational tools and consequently presents possible avenues for future research. Failure to address these issues will negatively impact on the adoption rate of the self-management tools and applications.
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Affiliation(s)
- Oveeyen Moonian
- Department of Digital Technologies, FoICDT, University of Mauritius
| | | | - Kavi Kumar Khedo
- Department of Digital Technologies, FoICDT, University of Mauritius
| | | | | | - Leckraj Nagowah
- Department of Software and Information Systems, FoICDT, University of Mauritius
| | | | - Sudha Cheerkoot-Jalim
- Department of Information and Communication Technologies, FoICDT, University of Mauritius
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16
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Paris I, Henry C, Pirard F, Gérard A, Colin IM. The new FreeStyle libre flash glucose monitoring system improves the glycaemic control in a cohort of people with type 1 diabetes followed in real-life conditions over a period of one year. Endocrinol Diabetes Metab 2018; 1:e00023. [PMID: 30815557 PMCID: PMC6354746 DOI: 10.1002/edm2.23] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 06/03/2018] [Indexed: 12/12/2022] Open
Abstract
AIMS Using the novel FreeStyle Libre (FSL), glucose monitoring (FGM) system becomes increasingly popular among people with type 1 diabetes (T1D) and is associated with less and shorter hypoglycaemic events without deterioration of HbA1c. There are not yet data reporting the impact of FGM in people with T1D in real-life conditions. We sought of evaluating the tolerance, the acceptance and the efficacy of the FGM system in routine medical practice. METHODS This 12-month observational study included 120 individuals with T1D evaluated every 3 months. After having been instructed about FGM utilization, participants were trained to optimize the glycaemic control. RESULTS Participants stopped immediately of measuring capillary blood glucose (2.88 ± 0.12 per day) (mean ± SEM) after having received the first FSL device and the number of scans per day increased up to 8.87 ± 0.58 per day. HbA1c levels decreased from 8.51% ± 0.14% at baseline to 7.77% ± 0.09% after 3 months to slightly increase to 7.92% ± 0.09% at 12 months, in correlation with the number of scans per day. The number (but not the duration) of hypoglycaemic events slightly increased from 16.9 ± 1.44 per month at baseline to 24.0 ± 2.91 per month at 12 months, after reaching a peak of 26.4 ± 2.31 per month at 6 months. They were correlated with improved HbA1c. CONCLUSION Our study shows that using the FGM system improves HbA1c levels in people with T1D along with a moderate increase in the number of mild hypoglycaemic events. The new FGM system facilitates the therapeutic empowerment of people with T1D, but in a context of structured education.
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Affiliation(s)
- Isabelle Paris
- Service d'Endocrino‐Diabétologie (CRPO)Unité de Recherche Clinique en Endocrinologie (URCE)Centre Hospitalier Régional (CHR) Mons‐HainautMonsBelgium
| | - Corinne Henry
- Service d'Endocrino‐Diabétologie (CRPO)Unité de Recherche Clinique en Endocrinologie (URCE)Centre Hospitalier Régional (CHR) Mons‐HainautMonsBelgium
| | - Françoise Pirard
- Service d'Endocrino‐Diabétologie (CRPO)Unité de Recherche Clinique en Endocrinologie (URCE)Centre Hospitalier Régional (CHR) Mons‐HainautMonsBelgium
| | - Anne‐Catherine Gérard
- Service d'Endocrino‐Diabétologie (CRPO)Unité de Recherche Clinique en Endocrinologie (URCE)Centre Hospitalier Régional (CHR) Mons‐HainautMonsBelgium
| | - Ides M. Colin
- Service d'Endocrino‐Diabétologie (CRPO)Unité de Recherche Clinique en Endocrinologie (URCE)Centre Hospitalier Régional (CHR) Mons‐HainautMonsBelgium
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17
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Garg SK, Akturk HK. A New Era in Continuous Glucose Monitoring: Food and Drug Administration Creates a New Category of Factory-Calibrated Nonadjunctive, Interoperable Class II Medical Devices. Diabetes Technol Ther 2018; 20:391-394. [PMID: 29901411 DOI: 10.1089/dia.2018.0142] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Satish K Garg
- Barbara Davis Center for Diabetes, University of Colorado Denver , Aurora, Colorado
| | - H Kaan Akturk
- Barbara Davis Center for Diabetes, University of Colorado Denver , Aurora, Colorado
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18
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Wang B, Qiao W, Ye W, Wang X, Liu Y, Wang YJ, Xiao YF. Comparison of Continuous Glucose Monitoring between Dexcom G4 Platinum and HD-XG Systems in Nonhuman Primates (Macaca Fascicularis). Sci Rep 2017; 7:9596. [PMID: 28851965 PMCID: PMC5575167 DOI: 10.1038/s41598-017-09806-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 07/28/2017] [Indexed: 01/26/2023] Open
Abstract
Timely knowing glucose level helps diabetic patients to manage the disease, including decisions about food, physical activity and medication. This study compared two continuous glucose monitoring systems in conscious and moving-free nonhuman primates (NHPs, Macaca fascicularis). Each normoglycemic or diabetic monkey was implanted with one Dexcom G4 Platinum subcutaneously or one HD-XG glucose sensor arterially for glucose monitoring. The glucose levels measured by both telemetry devices significantly correlated with the glucometer readings. The data of oral glucose tolerance test (oGTT) showed that the glucose levels measured by either Dexcom G4 Platinum or HD-XG transmitter were very similar to glucometer readings. However, compared to HD-XG transmitter or glucometer, Dexcom G4 Platinum detected a decreased glucose peak of ivGTT with approximately 10 min delay due to interstitial glucose far behind blood glucose change. Our data showed the advantages of the telemetry systems are: (1) consecutive data collection (day and night); (2) no bleeding; (3) no anesthesia (moving freely); (4) recording natural response without physical restriction and stress; (5) less labor intensity during ivGTT and other tests; (6) quick outcomes without lab tests. This article summarized and compared the differences of the general characteristics of two continuous glucose monitoring systems in diabetic research.
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Affiliation(s)
- Bingdi Wang
- Crown Bioscience, Inc., Taicang, Jiangsu Province, China
| | - Wei Qiao
- Crown Bioscience, Inc., Taicang, Jiangsu Province, China
| | - Weiwei Ye
- Crown Bioscience, Inc., Taicang, Jiangsu Province, China
| | - Xiaoli Wang
- Crown Bioscience, Inc., Taicang, Jiangsu Province, China
| | - Yongqiang Liu
- Crown Bioscience, Inc., Taicang, Jiangsu Province, China
| | - Yixin Jim Wang
- Crown Bioscience, Inc., Taicang, Jiangsu Province, China
| | - Yong-Fu Xiao
- Crown Bioscience, Inc., Taicang, Jiangsu Province, China.
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Affiliation(s)
- Satish K. Garg
- School of Medicine, University of Colorado Denver, Aurora, Colorado
- Barbara Davis Center for Diabetes, Aurora, Colorado
| | - Halis K. Akturk
- School of Medicine, University of Colorado Denver, Aurora, Colorado
- Barbara Davis Center for Diabetes, Aurora, Colorado
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