Glycemic variability in the development of cardiovascular complications in diabetes

Nusca, Annunziata; Tuccinardi, Dario; Albano, M; Cavallaro, Camilla; Ricottini, Elisabetta; Manfrini, Silvia; Pozzilli, Paolo; Sciascio, Germano Di

doi:10.1002/dmrr.3047

Cited by 125 publications

(123 citation statements)

References 97 publications

Supporting

Mentioning

114

Contrasting

Order By: Relevance

“…Further, nonexercise physical activity can aid in prevention and treatment of type 2 diabetes [19]. Both sustained hyperglycemia and large glucose fluctuations adversely affect cardiovascular health of diabetic subjects [20].…”

Section: Introductionmentioning

confidence: 99%

“…Reduction of time spent in hyperglycemia is important, since microvascular and macrovascular complications and proinflammatory phenotype in diabetes have been shown from chronic sustained hyperglycemia and acute glycemic fluctuations [20,32]. While there are strong grounds to con-tinue to emphasize importance of regular aerobic and muscle-strengthening activities to prevent and manage type 2 diabetes, JD offers a solution to negate the adverse glycemic effects of high amounts (i.e., hours) of sitting in the adult population.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Portable Gentle Jogger Improves Glycemic Indices in Type 2 Diabetic and Healthy Subjects Living at Home: A Pilot Study

Adams

Banderas²,

López

et al. 2020

Journal of Diabetes Research

View full text Add to dashboard Cite

Background. Physical inactivity is a high-risk factor for type 2 diabetes. Increased physical activity improves indices of glycemic control. Continuous glucose monitoring (CGM) allows the investigation of glycemic control during activities of daily living. A pilot study was undertaken to determine the effects of the portable Gentle Jogger (passive simulated jogging device (JD)) that decreases physical inactivity by effortlessly producing body movements on glycemic indices of healthy and type 2 diabetes subjects using CGM during activities of daily living. Methods. A single-arm, nonblinded study was carried out in 22 volunteers (11 type 2 diabetics and 11 healthy subjects), using continuous glucose monitoring (CGM) for 14 days. On day 4, subjects were provided with JD and instructed to use it a minimum of 3 times per day for 30 min for 7 days. CGM data was analyzed at baseline (BL) and during 2, 3, 4, 5, 6, and 7 days of JD (JD 2, 3, 4, 5, 6, 7) and 1-2-day post JD (Post JD1 and 2) and the following 24 hr indices computed mean glucose (mGLu), SUM of all glucose values, % coefficient of variation (%CV), area under the 24-hour curve (AUC), time spent above range (TAR, glucose 180-250 mg/dl), and time in range (TIR). Results. In healthy subjects, there were significantly lower values of mGlu and SUM compared to BL for all days of JD usage. In type 2 diabetics, mGlu, SUM, and AUC were significantly lower compared to BL, for all days of JD usage and Post JD1. TAR was significantly lower and TIR significantly improved during JD, in type 2 diabetics without change in %CV. Conclusion. Gentle Jogger is a portable, passive movement technology that reduces physical inactivity while improving 24 hr glycemic control. It can be self-administered as a standalone device or as an adjunct to diabetic medications. This trial is registered with NCT03550105.

show abstract

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Portable Gentle Jogger Improves Glycemic Indices in Type 2 Diabetic and Healthy Subjects Living at Home: A Pilot Study

Adams

Banderas²,

López

et al. 2020

Journal of Diabetes Research

View full text Add to dashboard Cite

show abstract

“…Glycemic variability from target range, a complex phenomenon of intraday and interday glucose fluctuations, as well as time in range has emerged as strong measures for assessing glycemic control in addition to HbA1c. [34][35][36][37] Glycemic variability is an independent risk factor for diabetic complications 38 and is often expressed as standard deviation, coefficient of variation/variance, mean amplitude glycemic excursion, and a host of other metrics. Postmeal glucose excursions largely contribute to the intraday glycemic variability and can be more effectively managed using prandial doses of rapid-acting insulin analogues.…”

Section: Glycemic Variabilitymentioning

confidence: 99%

Precision Dosing of Rapid-Acting Insulin Matters

Aanstoot¹,

Rodriguez

Weinzimer

et al. 2020

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

Despite several molecular and technological advances in insulin therapy and insulin delivery, global evidence highlights inadequate glycemic control in populations with type 1 diabetes (T1D) and type 2 diabetes (T2D). In this review, we discuss the importance of more precise dosing of insulin as one of the approaches to improve glycemic control while reducing hypoglycemic events. This report is based on the expert opinion of authors and literature search of articles relevant to the past and present insulin delivery devices in diabetes management, especially half-unit insulin pens. We describe the various factors that facilitate better glycemic control, focusing on the impact of appropriate insulin delivery device selection on diabetes management. Precision dosing of insulin is a lesser-studied factor that contributes toward better glycemic control. Insulin pens have consistently outperformed syringes as delivery devices due to their greater accuracy and precision of dosing, ease-of-use, and patient preference. These advantages make them better suited to administer insulin in hypoglycemia-prone insulin-sensitive people with T1D, particularly younger children and geriatric patients. Half-unit insulin pens further extend this benefit by delivering half-unit doses of insulin accurately. They may contribute to better management of diabetes by allowing flexible dosing for mealtimes and physical activities even in erratic diet situations or illnesses by offering corrective doses in small increments. They are ideal delivery devices for insulin-sensitive people with T1D who require greater accuracy and precision in insulin delivery to achieve more stringent glycemic control.

show abstract

“…36,78 Another 1-year study found the low-carbohydrate diet resulted in decreased glucose variability, which has been found to be an independent CVD risk factor, making it an important overall consideration. 85 An isocaloric trial found the low-carbohydrate arm had a significant decrease in insulin and visceral fat accumulation compared to a high-carbohydrate arm. 70 Of the 10 studies that reported on lipids, five found significant improvements in triglycerides with a low-carbohydrate diet 74,78,[82][83][84] ;…”

Section: Summary Of Evidencementioning

confidence: 99%

Improving the scientific rigour of nutritional recommendations for adults with type 2 diabetes: A comprehensive review of the American Diabetes Association guideline‐recommended eating patterns

Hallberg

Dockter²,

Kushner³

et al. 2019

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Aims The global rate of type 2 diabetes (T2D) continues to rise. Guidelines that influence the worldwide treatment of this disease are central to changing this trajectory. We sought in this review to evaluate the appropriateness of sources cited in the American Diabetes Association's (ADA) guidelines on eating patterns for T2D management, identify additional relevant sources, and evaluate the evidence. Materials and Methods We reviewed the evidence behind the ADA's recommendations on eating patterns in the 2018 and 2019 ADA Standards of Care and the 2014 ADA Nutrition Therapy Recommendations for Adults with Diabetes. Additionally, we conducted a comprehensive search to identify any additional studies not included in the cited evidence. To determine appropriateness of inclusion in the guidelines, the following criteria were applied: 1) it was a clinical trial or systematic review/meta‐analysis of clinical trials; 2) it involved persons with T2D; 3) one of the study arms followed one of the eating patterns currently recommended; 4) its reported outcomes included glycaemic control; 5) outcomes were reported separately for persons with T2D. Results We found a wide variation in the evidence for each eating pattern. Issues that have hampered the guideline process include: lack of a rigorous literature review, resulting in the omission of pertinent studies; an overreliance on prospective cohort studies; inconsistent standards for evidence; inclusion of studies not on persons with T2D; and bias. Conclusions The ADA Guidelines recommended eating patterns fall short of rigorous standards of scientific review according to state‐of‐the‐art systematic review and guideline creation practices.

show abstract

Glycemic variability in the development of cardiovascular complications in diabetes

Cited by 125 publications

References 97 publications

Portable Gentle Jogger Improves Glycemic Indices in Type 2 Diabetic and Healthy Subjects Living at Home: A Pilot Study

Portable Gentle Jogger Improves Glycemic Indices in Type 2 Diabetic and Healthy Subjects Living at Home: A Pilot Study

Precision Dosing of Rapid-Acting Insulin Matters

Improving the scientific rigour of nutritional recommendations for adults with type 2 diabetes: A comprehensive review of the American Diabetes Association guideline‐recommended eating patterns

Contact Info

Product

Resources

About