Chinese clinical guidelines for continuous glucose monitoring (2018 edition)

Bao, Yuqian; Chen, Li; Chen, Liming; Dou, Jingtao; Gao, Zhengnan; Gao, Leili; Guo, Lixin; Guo, Xiaokui; Ji, Linong; Ji, Qiuhe; Jia, Weiping; Kuang, Hongyu; Li, Qifu; Li, Qiang; Li, Xiaoying; Li, Yanbing; Li, Ling; Liu, Jing; Ma, Jianhua; Ran, Xingwu; Shi, Lixin; Song, Guangyao; Wang, Yufei; Weng, Jianping; Xiao, Xinhua; Xie, Yizhen; Xi, Guangxia; Yang, Liyong; Zhi-gang, Zhao; Zhou, Jian; Zhang, Zhou; Zhu, Dalong; Zou, Da-jin

doi:10.1002/dmrr.3152

Cited by 14 publications

(10 citation statements)

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“…On the basis of self blood glucose monitoring (SBGM), patients with good glycemic control appear to have lower mortality during hospitalization than those with suboptimal control (4). Unlike SBGM, continuous glucose monitoring (CGM) provides a comprehensive view of patients' interstitial glucose levels, permitting quantification of hyperglycemia, hypoglycemia, and glycemic variability (5). CGM might allow better glycemic control, with a reasonable target of glycemic control in patients with diabetes and COVID-19 (6).…”

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confidence: 99%

Thresholds of Glycemia and the Outcomes of COVID-19 Complicated With Diabetes: A Retrospective Exploratory Study Using Continuous Glucose Monitoring

et al. 2021

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Although elevated glucose levels are reported to be associated with adverse outcomes of coronavirus disease 2019 (COVID-19), the optimal range of glucose in patients with COVID-19 and diabetes remains unknown. This study aimed to investigate the threshold of glycemia and its association with the outcomes of COVID-19. RESEARCH DESIGN AND METHODS Glucose levels were assessed through intermittently scanned continuous glucose monitoring in 35 patients for an average period of 10.2 days. The percentages of time above range (TAR), time below range (TBR), time in range (TIR), and coefficient of variation (CV) were calculated. Composite adverse outcomes were defined as either the need for admission to the intensive care unit, need for mechanical ventilation, or morbidity with critical illness. RESULTS TAR using the threshold of 160-200 mg/dL was significantly associated with composite adverse outcomes after adjustment of covariates. Both TBR (<70 mg/dL) and TIR (70-160 mg/dL), but not mean sensor glucose level, were significantly associated with composite adverse outcomes and prolonged hospitalization. The multivariate-adjusted odds ratios of the CV of sensor glucose across tertiles for composite adverse outcomes of COVID-19 were 1.00, 1.18, and 25.2, respectively. CONCLUSIONS Patients with diabetes and COVID-19 have an increased risk of adverse outcomes with glucose levels >160 mg/dL and <70 mg/dL and a high CV. Therapies that improve these metrics of glycemic control may result in better prognoses for these patients. Epidemiological studies have reported that approximately one-half of patients with coronavirus disease 2019 (COVID-19) have comorbidities, of which diabetes is the second most common (1,2). There was more than a fourfold chance of patients with diabetes and COVID-19 meeting the primary composite end point of need for intensive

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confidence: 99%

Thresholds of Glycemia and the Outcomes of COVID-19 Complicated With Diabetes: A Retrospective Exploratory Study Using Continuous Glucose Monitoring

et al. 2021

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“…Furthermore, to investigate what subpopulation of people with T2DM benefitted more from the FGM, we divided patients into 3 groups (n = 37) by the tertiles of baseline HbA1c (high concentration group [HC group, HbA1c ≥ 66. 1…”

Section: Methodsmentioning

confidence: 99%

“…Glucose monitoring is an important part of diabetes management in evaluating the glucose metabolism disorder and adjusting antidiabetic therapy [1]. Although self-monitoring of plasma glucose (SMPG) was a traditional method of glucose monitoring, it is associated with pain and inconvenience which may lead to failure of SMPG [2,3].…”

Section: Introductionmentioning

confidence: 99%

Flash Glucose Monitoring Improves Glucose Control in People with Type 2 Diabetes Mellitus Receiving Anti-diabetic Drug Medication

Chen

Shen

et al. 2020

Exp Clin Endocrinol Diabetes

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Objective To investigate the effects of Flash Glucose Monitoring (FGM) on glucose profile in people with Type 2 Diabetes Mellitus (T2DM) receiving anti-diabetic drug medication. Methods This is a prospective non-randomized uncontrolled study. 111 people with T2DM were enrolled and received FGM for 14 days. There was no change of anti-diabetic medication during the 14 days. The plasma glucose concentration on day 2 was used as baseline and the day 13 was considered as study end point. The parameters to compare were mean plasma glucose (MPG), glucose variations, and incidence of hypoglycemia during the FGM period. The multivariate linear stepwise regression analysis was applied to determine the independent factors that affect MPG difference. Results This study analyzed the data of a total of 111 people with T2DM (male 60 and female 51). The general clinical data of these patients were as follows: age: 65.0±6.7 years old; duration of diabetes: 11.6±6.8 years; HbA1c: 61.2±13.3 mmol/mol; body mass index (BMI): 25.2±3.2 kg/m². Using FGM, people with T2DM were able to change daily diet and exercise through which significant reductions in MPG on days 12 or 13 were achieved as compared with that of day 2 (P=0.04 or P=0.003, respectively). The glucose variations, such as standard deviation (SD) of plasma glucose, coefficient of variation (CV), and mean amplitude of glycemic excursion (MAGE), progressively declined starting from day 6 as compared with baseline (P=0.016, P=0.003, or P=0.012, respectively). The incremental area over the curve (AOC) of the hypoglycemia (<3.9 mmol/L) had a significant reduction starting from the day 3 (P=0.001). When people with T2DM were divided into 3 groups based on the tertile of HbA1c (high, middle, and low concentrations), the reduction of MPG in patients with high concentration of HbA1c were much larger than that in middle and low concentration group patients (P=0.001 for both). The incidence of hypoglycemia was improved in the low concentration group (P=0.017). The optimal frequency of scanning time required to maintain euglycemia was 11.7 times/day as calculated by the receiver operating characteristic (ROC) analysis. Conclusion Using FGM to monitor glucose concentration at 11.7 times/day, people with T2DM can achieve a better glucose control in addition to anti-diabetic drug medication through changing daily diet and exercise, especially in patients with high concentration of HbA1c (>66.1 mmol/mol).

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“…52 Though the primary end point of reduction in HbA1c was not reached in this study, the control group was checking FSBG data more frequently than commonly performed by most people with T2DM. Accordingly, personal CGM systems are now considered the standard of care for individuals with T1DM and commonly considered for insulin-treated diabetes in countries like the United States 53 and China 54 and are the emerging standard of care for other countries. Many unique CGM system features factor into the selection process of the CGM brand, including perceived utility and accuracy, ease of use, cost, and insurance coverage (Table 3).…”

Section: Glucose-monitoring Devices and Applicationsmentioning

confidence: 99%

Emerging technologies for the management of type 2 diabetes mellitus

Shah

Levy

2021

Journal of Diabetes

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Diabetes mellitus is a global health problem affecting 422 million people worldwide, of which 34.2 million live in the United States alone. Complications due to diabetes can lead to considerable morbidity and mortality related to both microvascular and macrovascular disease. While glycosylated hemoglobin testing is the standard test utilized to evaluate glycemic control, emerging targets like "time in range" and "glycemic variability" often provide more accurate assessments of glycemic fluctuations and have implications for diabetes complications and quality of life. Patients with diabetes face considerable burdens of self-care including frequent glucose monitoring, multiple insulin injections, dietary management, and the need to track daily activities, all of which lead to reduced adherence and psychological burnout. From the provider perspective, limited patient data and access to self-management tools lead to treatment inertia and a reduced ability to help patients achieve and maintain their glycemic goals. In the past few decades, there have been considerable advances in treatment-based technology and technological applications designed to help reduce patient burden and provide tools for better self-management. These advances make real-time clinical data available for clinicians to make necessary changes in treatment regimens. In this review, we discuss the latest emerging technologies available for the management of people with type 2 diabetes mellitus. K E Y W O R D S technology, type 2 diabetes mellitus HighlightsThe use of technology in diabetes self-management and education has expanded significantly over the past few decades and offers platforms for the rapid development of patient-centered interventions to achieve optimal glycemic control. Utilization of technology has the potential to lessen patient burden by seamlessly integrating real-time feedback into patients' daily lifestyle and provide an option for review of health data remotely by care teams. We

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Chinese clinical guidelines for continuous glucose monitoring (2018 edition)

Cited by 14 publications

References 82 publications

Thresholds of Glycemia and the Outcomes of COVID-19 Complicated With Diabetes: A Retrospective Exploratory Study Using Continuous Glucose Monitoring

Thresholds of Glycemia and the Outcomes of COVID-19 Complicated With Diabetes: A Retrospective Exploratory Study Using Continuous Glucose Monitoring

Flash Glucose Monitoring Improves Glucose Control in People with Type 2 Diabetes Mellitus Receiving Anti-diabetic Drug Medication

Emerging technologies for the management of type 2 diabetes mellitus

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