Current methods of assessing blood glucose control in diabetes

Evans, Mark L.

doi:10.15277/bjd.2016.071

Cited by 8 publications

(6 citation statements)

References 4 publications

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“…In FGM, glucose data could be stored for up to 8 h on a sensor and a handheld reader could be used to obtain them conveniently. Moreover, the FGM sensor is factory-calibrated and can be worn for up to 14 days, which improves the patients’ qualitiy of life 20 .…”

Section: Discussionmentioning

confidence: 99%

Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring

Zhang

Liu

Sun

et al. 2021

Sci Rep

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Flash glucose monitoring (FGM) was introduced in China in 2016, and it might improve HbA1c measurements and reduce glycaemic variability during T1DM therapy. A total of 146 patients were recruited from October 2018 to September 2019 in Liaocheng. The patients were randomly divided into the FGM group or self-monitoring blood glucose (SMBG) group. Both groups wore the FGM device for multiple 2-week periods, beginning with the 1st, 24th, and 48th weeks for gathering data, while blood samples were also collected for HbA1c measurement. Dietary guidance and insulin dose adjustments were provided to the FGM group patients according to their Ambulatory Glucose Profile (AGP) and to the SMBG group patients according to their SMBG measurements taken 3–4 times daily. All of the participants underwent SMBG measurements on the days when not wearing the FGM device. At the final visit, HbA1c, time in range (TIR), duration of hypoglycaemia and the number of diabetic ketoacidosis (DKA) events were taken as the main endpoints. There were no significant difference in the baseline characteristics of the two groups. At 24 weeks, the HbA1c level of the FGM group was 8.16 ± 1.03%, which was much lower than that of the SMBG group (8.68 ± 1.01%) (p = 0.003). The interquartile range (IQR), mean blood glucose (MBG), and the duration of hypoglycaemia in the FGM group also showed significant declines, compared with the SMBG group (p < 0.05), while the TIR increased in the FGM group [(49.39 ± 17.54)% vs (42.44 ± 15.49)%] (p = 0.012). At 48 weeks, the differences were more pronounced (p < 0.01). There were no observed changes in the number of episodes of DKA by the end of the study [(0.25 ± 0.50) vs (0.28 ± 0.51), p = 0.75]. Intermittent use of FGM by T1DM patients can improve their HbA1c and glycaemic control without increasing the hypoglycaemic exposure in insulin-treated individuals with type 1 diabetes in an developing country.

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Section: Discussionmentioning

confidence: 99%

Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring

Zhang

Liu

Sun

et al. 2021

Sci Rep

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“…15 Hence self-monitored blood sugar level diary is still a valid option with its own limitations. 16 Based on clinical observational note from diabetes register at CHA, analysis focused on evaluation of prevalence of laboratory methods of diabetes diagnosis and monitoring of glucose control. Another focus was on obesity and dyslipidaemia in diabetes patients in the register as well as metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

Development of diabetes register in low-mid income country: survey of healthcare professionals’ behavioural change wheel

Igumbor

Agofure

Oshionwu³

et al. 2019

Int J Community Med Public Health

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Background: There has been and ongoing research and development on diabetes care in Ndokwa community of Nigeria, and one of the items to be addressed is development of diabetes register in some of the health facilities. This study assesses the behavioural change wheel of the healthcare professionals to address the willingness of the primary healthcare providers willing to scale up and sustain the diabetes register; and how glycaemic control and metabolic syndrome factors in diabetes patients were assessed.Methods: The study adopted clinical observational approach and survey questionnaires. A descriptive cross sectional method evaluated how glycaemic control among diabetes patients (n=42) was assessed. Clinical observations were at Catholic Hospital Abbi, while the survey of healthcare professionals (n=71) included health facilities in other communities. Data from questionnaire and test results was analysed using Microsoft Excel Data Analysis Toolpak 2010.Results: It is observed that 62% wished they had a diabetes register. Over 50% of the patients showed presence of >2 metabolic syndrome indices. Further, ≈52% disagreed that diet, exercise, medication, quitting smoking and less stress contributed to effective control and management of diabetes.Conclusions: Most of the respondents thought that their practice did not have a special interest in diabetes. There is prevalence of metabolic syndrome, but the majority of healthcare professionals did not view lifestyle as effective to control diabetes. These observations highlight the need for diabetic education on healthcare professionals and patients.

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“…Although current BG meters are very accurate, require small amounts of blood, are very attractive, and some even communicate with insulin pumps [8, 9], SMBG presents a burden for children and their parents because of pain and discomfort associated with the finger-stick capillary blood sampling and accumulated injury to the fingers [10, 11]. Moreover, SMBG by intermittent capillary sampling gives only snapshots of BG concentrations with no information of the glycaemic profile in between the sampling moments [12]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

et al. 2018

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Background/Aims: The FreeStyle® Libre Flash Glucose Monitoring System (FGM, Abbott) measures glucose concentrations in the interstitial fluid for up to 14 days. It has been approved for use in children aged > 4 years in January 2016. Experience in children is still limited. We evaluated the accuracy and usability of the FGM in children with type 1 diabetes mellitus (DM). Methods: 67 children with type 1 DM (35 girls), aged 4–18 years, were included. Subjects wore a sensor on the back of their upper arm. For the first 14 days, they regularly measured capillary blood glucose (BG) with their usual BG meter (Accu-Chek® Mobile [ACM], Roche [n = 24]; Contour® Next Link [CNL], Bayer [n = 26]; OneTouch® Verio® IQ [OTV], LifeScan [n = 17]) followed by a sensor glucose (SG) scanning. SG readings were compared to BG measurements by consensus error grid (CEG) analysis; the mean difference (MD), the mean relative difference (MRD), the mean absolute difference (MAD), and the mean absolute relative difference (MARD) were calculated. After 14 days, subjects were asked to fill in a questionnaire on the usability of the FGM. Results: 2,626 SG readings were paired with BG results. FGM readings were highly correlated with BG (r = 0.926, p < 0.001). 80.3% of the data pairs were in zone A (= no effect on clinical action) and 18.4% were in zone B (= altered clinical action with little or no effect on the clinical outcome) of the CEG. Overall MD was +7.5 mg/dL; MD varied with the BG meter: ACM +10.4 mg/dL, CNL +14.2 mg/dL, OTV –3.6 mg/dL (p < 0.001). Overall, MARD was 16.7%. We observed a large interindividual variability in the accuracy parameters. MD and MRD were inversely related to BMI (r = –0.261 [p < 0.05]; r = –0.266 [p < 0.05], respectively). MARD was inversely related to age (r = –0.266 [p < 0.05]). Twenty-nine patients (43.3%) reported sensor problems, mainly early detachment of the sensor. Nonetheless, the usability questionnaire indicated high levels of satisfaction. Conclusions: Our results showed a reasonable agreement between the FGM SG readings and capillary BG measurements in children. There was, however, a large interindividual variability. The wearing of the sensor requires special attention. Further studies in children are imperative in order to document the accuracy and safety of the FGM in the paediatric population.

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Current methods of assessing blood glucose control in diabetes

Cited by 8 publications

References 4 publications

Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring

Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring

Development of diabetes register in low-mid income country: survey of healthcare professionals’ behavioural change wheel

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

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