Flash glucose monitoring in type 1 diabetes: A comparison with self‐monitoring blood glucose

Babaya, Naru; Noso, Shinsuke; Hiromine, Yoshihisa; Taketomo, Yasunori; Niwano, Fumimaru; Yoshida, Sawa; Yasutake, Sara; Kawabata, Yumiko; Ikegami, Hiroshi

doi:10.1111/jdi.13229

Cited by 12 publications

(6 citation statements)

References 19 publications

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“…In addition, CGM could not be carried out for every participant who started the administration of an SGLT2i. Furthermore, a previous study showed that CGM values were lower than SMBG values in the lower glucose range, and higher in the higher glucose range 23 . Capillary and venous glucose concentrations are similar under steady‐state conditions, but might differ under dynamic conditions 24 .…”

Section: Discussionmentioning

confidence: 97%

Sodium–glucose cotransporter 2 inhibitors reduce day‐to‐day glucose variability in patients with type 1 diabetes

Chiba

Nishimura

Nakamura

et al. 2020

J of Diabetes Invest

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Aims/Introduction Sodium–glucose cotransporter 2 inhibitors (SGLT2i) are used worldwide because of their multiple benefits for patients with type 2 diabetes. The purpose of this study was to determine the efficacy and safety of SGLT2i in patients with type 1 diabetes. Materials and Methods Patients with type 1 diabetes who had been treated with SGLT2i for >12 weeks were included in this retrospective observation study. We recorded the changes in body mass, insulin dose, blood and urine test data, and adverse events. The changes in day‐to‐day glucose variability, as the primary end‐point, was evaluated using the interquartile range (P25/P75) of the ambulatory glucose data obtained using continuous glucose monitoring. Results A total of 51 patients (37 women; mean age 52.7 years) were included. Glycated hemoglobin and body mass significantly decreased by 0.4% and 1.6 kg, respectively. The total required insulin dose decreased by 9.4% (42.7 ± 26.6–38.7 ± 24.3 units/day). Continuous glucose monitoring data were obtained from 30 patients. P25/P75 decreased by 17.6 ± 20.7% during SGLT2i treatment (P < 0.001). The percentage of time per day within the target glucose range of 70–180 mg/dL significantly increased (from 42.2 to 55.5%, P < 0.001), without an increase in the percentage of time spent in the hypoglycemic range (<70 mg/dL). Urinary ketone bodies were detected in four patients (7.8%), but none developed ketoacidosis. Conclusions SGLT2i improved day‐to‐day glucose variability and time in the target glucose range, without increasing frequency of hypoglycemia, in patients with type 1 diabetes, and reduced glycated hemoglobin, body mass and the required insulin dose.

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Section: Discussionmentioning

confidence: 97%

Sodium–glucose cotransporter 2 inhibitors reduce day‐to‐day glucose variability in patients with type 1 diabetes

Chiba

Nishimura

Nakamura

et al. 2020

J of Diabetes Invest

View full text Add to dashboard Cite

show abstract

“…p-values < 0.05 were considered as statistically significant. Thieme Article tion, a recent publication by Babaya et al [26] showed that glucose values determined by system A were lower in the low glucose range, and higher in the high glucose range than corresponding SMBG values. Since the TbR < 54 and TbR < 70 of system A was about 25-50 % higher than that of system B, this could be a reason for the lower mean glucose and the correspondingly lower GMI value of system A and highlights the clinical relevance of differences in the accuracy of CGM systems, their derived metrics and the resulting decisions.…”

Section: Discussionmentioning

confidence: 98%

Choice of Continuous Glucose Monitoring Systems May Affect Metrics: Clinically Relevant Differences in Times in Ranges

Freckmann

Pleus

Schauer

et al. 2021

Exp Clin Endocrinol Diabetes

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Background Continuous glucose monitoring-derived parameters are becoming increasingly important in the treatment of people with diabetes. The aim of this study was to assess whether these parameters, as calculated from different continuous glucose monitoring systems worn in parallel, are comparable. In addition, clinical relevance of differences was investigated. Methods A total of 24 subjects wore a FreeStyle Libre (A) and a Dexcom G5 (B) sensor in parallel for 7 days. Mean glucose, coefficient of variation, glucose management indicator and time spent in different glucose ranges were calculated for each system. Pairwise differences between the two different continuous glucose monitoring systems were computed for these metrics. Results On average, the two CGM systems indicated an identical time in range (67.9±10.2 vs. 67.9±11.5%) and a similar coefficient of variation; both categorized as unstable (38.1±5.9 vs. 36.0±4.8%). In contrast, the mean time spent below and above range, as well as the individual times spent below, in and above range differed substantially. System A indicated about twice the time spent below range than system B (7.7±7.2 vs. 3.8±2.7%, p=0.003). This could have led to different therapy recommendations in approximately half of the subjects. Discussion The differences in metrics found between the two continuous glucose monitoring systems may result in different therapy recommendations. In order to make adequate clinical decisions, measurement performance of CGM systems should be standardized and all available information, including the HbA1c, should be utilized.

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“…Because glycemic variability is a significant and independent determinant of hypoglycemia in patients with type 2 diabetes mellitus on insulin therapy 19 , once the dose of insulin or sulfonylurea has been adjusted appropriately, TBR should be rather decreased by the combination therapy through an improvement in glycemic variability 9 . Previous studies showed that CGM values were lower than self‐monitoring blood glucose values in the low glucose range 20 , and that capillary and venous glucose concentrations can differ under dynamic conditions 21 . Therefore, CGM data might not be highly accurate and the possibility of such inaccuracies should be considered, especially in the low glucose region.…”

Section: Discussionmentioning

confidence: 99%

Improved time in range and postprandial hyperglycemia with canagliflozin in combination with teneligliptin: Secondary analyses of the CALMER study

Cho

Nishimura

Nakamura

et al. 2021

J of Diabetes Invest

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Aims/Introduction We recently reported the beneficial effect of the combination of sodium–glucose cotransporter 2 inhibitor and dipeptidyl peptidase‐4 inhibitor on daily glycemic variability in patients with type 2 diabetes mellitus. Additional favorable effects of combination therapy were explored in this secondary analysis. Materials and Methods The CALMER study was a multicenter, open‐label, prospective, randomized, parallel‐group comparison trial for type 2 diabetes mellitus involving continuous glucose monitoring under meal tolerance tests. Patients were randomly assigned to switch from teneligliptin to canagliflozin (SWITCH group) or to add canagliflozin to teneligliptin (COMB group). The continuous glucose monitoring metrics, including time in target range, were investigated. Results All 99 participants (mean age 62.3 years; mean glycated hemoglobin 7.4%) completed the trial. The time in target range was increased in the COMB group (71.2–82.7%, P < 0.001). The extent of the reduction in time above target range was significantly larger in the COMB group compared with the SWITCH group (−14.8% vs −7.5%, P < 0.01). Area under the curve values for glucose at 120 min after all meal tolerance tests were significantly decreased in the COMB group compared with the SWITCH group (P < 0.05). Conclusions Sodium–glucose cotransporter 2 inhibitor combined with dipeptidyl peptidase‐4 inhibitor improved the quality of glycemic variability and reduced postprandial hyperglycemia compared with each monotherapy.

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Flash glucose monitoring in type 1 diabetes: A comparison with self‐monitoring blood glucose

Cited by 12 publications

References 19 publications

Sodium–glucose cotransporter 2 inhibitors reduce day‐to‐day glucose variability in patients with type 1 diabetes

Sodium–glucose cotransporter 2 inhibitors reduce day‐to‐day glucose variability in patients with type 1 diabetes

Choice of Continuous Glucose Monitoring Systems May Affect Metrics: Clinically Relevant Differences in Times in Ranges

Improved time in range and postprandial hyperglycemia with canagliflozin in combination with teneligliptin: Secondary analyses of the CALMER study

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