Increased Glycemic Variability at the Onset and During Progression of Type 2 Diabetes—Commentary

Rodbard, David

doi:10.1089/dia.2013.0146

Cited by 14 publications

(14 citation statements)

References 16 publications

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“…We observed a signi cantly increase in SD in patients receiving dexamethasone therapy compared to those of control group. Although the values of MAGE between the two groups failed to achieve statistically Although researchers indicate that there was a high degree of correlation between SD and MAGE [21,22]. We only observed a discernable increase in MAGE values in patients receiving dexamethasone therapy, which may be the modest sample size in this study.…”

Section: Discussioncontrasting

confidence: 55%

The Magnitude of Dexamethasone-Induced Hyperglycemia in Cataract Surgical Patients with Normal Glucose Metabolism- A Continuous Glucose Monitoring Based Study

Zhang¹,

Gu²,

Sun³

et al. 2020

Preprint

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Background: To determined 24-hrs glycemic variations using continuous glucose monitoring (CGM) in cataract surgical patients with normal glucose metabolism receiving dexamethasone therapy.Methods: This was a single-center, randomized, observational and prospective trial. Between June 2017 and December 2018, cataract surgical patients with normal glucose toleration were recruited, and were randomized assigned at a ratio of 1:2 to either receiving 10 mg dexamethasone daily for 3 days after cataract surgical (dexamethasone group) or without dexamethasone therapy (control group). A retrospective CGM was performed at afternoon on -1 day before cataract operation performed for at least 3 days. The primary endpoint was the difference in mean amplitude of glycemic excursions (MAGE) between the two groups.Results: We observed that patients receiving 10 mg dexamethasone daily showing mild increase in mean glucose and hourly mean glucose throughout 24-hrs compared to control group. We also detected that dexamethasone leading to a significant increase in glycemic variation, in term of standard deviation, and a number increase in MAGE and CV%.Conclusion: Our data reveal that short period administration of dexamethasone leading a mild increase in glycemic variations (GV). However, the increased GV may have not clinically relevant. Our data indicates that short duration of 10 mg dexamethasone once daily may be a safe therapy regarding glycemic metabolism in subjects without diabetes.

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Section: Discussioncontrasting

confidence: 55%

The Magnitude of Dexamethasone-Induced Hyperglycemia in Cataract Surgical Patients with Normal Glucose Metabolism- A Continuous Glucose Monitoring Based Study

Zhang¹,

Gu²,

Sun³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…We observed a significantly increase in SD in patients receiving dexamethasone therapy compared to those of control group. Although the values of MAGE between the two groups failed to achieve statistically Although researchers indicate that there was a high degree of correlation between SD and MAGE [21,22]. We only observed a discernable increase in MAGE values in patients receiving dexamethasone therapy, which may be the modest sample size in this study.…”

Section: Discussioncontrasting

confidence: 55%

The magnitude of dexamethasone-induced hyperglycemia in cataract surgical patients with normal glucose metabolism: a continuous glucose monitoring based study

Zhang¹,

Gu²,

Sun³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background To determined 24-hrs glycemic variations using continuous glucose monitoring (CGM) in cataract surgical patients with normal glucose metabolism receiving dexamethasone therapy.Methods This was a single-center, randomized, observational and prospective trial. Between June 2017 and December 2018, cataract surgical patients with normal glucose toleration were recruited, and were randomized assigned at a ratio of 1:2 to either receiving 10 mg dexamethasone daily for 3 days after cataract surgical (dexamethasone group) or without dexamethasone therapy (control group). A retrospective CGM was performed at afternoon on -1 day before cataract operation performed for at least 3 days. The primary endpoint was the difference in mean amplitude of glycemic excursions (MAGE) between the two groups. ResultsWe observed that patients receiving 10 mg dexamethasone daily showing mild increase in mean glucose and hourly mean glucose throughout 24-hrs compared to control group. We also detected that dexamethasone leading to a significant increase in glycemic variation, in term of standard deviation, and a number increase in MAGE and CV%.Conclusion Our data reveal that short period administration of dexamethasone leading a mild increase in glycemic variations (GV). However, the increased GV may have not clinically relevant. Our data indicates that short duration of 10 mg dexamethasone once daily may be a safe therapy regarding glycemic metabolism in subjects without diabetes.

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“…GV increases progressively as people develop impaired fasting glucose, impaired glucose tolerance, and finally overt type 2 diabetes. [58][59][60][61] After development of type 2 diabetes, with progressive loss of beta cell function, there is usually periodic advancement in the intensity of therapy, from mono-, to dual-, to triple-therapy, and finally to injectables (insulin, GLP-1RA agents, or both). Accordingly, the form of therapy can be used as a surrogate for the duration and severity of diabetes.…”

Section: Flash Glucose Monitoringmentioning

confidence: 99%

Continuous Glucose Monitoring: A Review of Recent Studies Demonstrating Improved Glycemic Outcomes

Rodbard¹

2017

Diabetes Technology & Therapeutics

Self Cite

367

267

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Continuous Glucose Monitoring (CGM) has been demonstrated to be clinically valuable, reducing risks of hypoglycemia and hyperglycemia, glycemic variability (GV), and improving patient quality of life for a wide range of patient populations and clinical indications. Use of CGM can help reduce HbA1c and mean glucose. One CGM device, with accuracy (%MARD) of approximately 10%, has recently been approved for selfadjustment of insulin dosages (nonadjuvant use) and approved for reimbursement for therapeutic use in the United States. CGM had previously been used off-label for that purpose. CGM has been demonstrated to be clinically useful in both type 1 and type 2 diabetes for patients receiving a wide variety of treatment regimens. CGM is beneficial for people using either multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). CGM is used both in retrospective (professional, masked) and real-time (personal, unmasked) modes: both approaches can be beneficial. When CGM is used to suspend insulin infusion when hypoglycemia is detected until glucose returns to a safe level (low-glucose suspend), there are benefits beyond sensor-augmented pump (SAP), with greater reduction in the risk of hypoglycemia. Predictive low-glucose suspend provides greater benefits in this regard. Closed-loop control with insulin provides further improvement in quality of glycemic control. A hybrid closed-loop system has recently been approved by the U.S. FDA. Closed-loop control using both insulin and glucagon can reduce risk of hypoglycemia even more. CGM facilitates rigorous evaluation of new forms of therapy, characterizing pharmacodynamics, assessing frequency and severity of hypo-and hyperglycemia, and characterizing several aspects of GV.

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Increased Glycemic Variability at the Onset and During Progression of Type 2 Diabetes—Commentary

Cited by 14 publications

References 16 publications

The Magnitude of Dexamethasone-Induced Hyperglycemia in Cataract Surgical Patients with Normal Glucose Metabolism- A Continuous Glucose Monitoring Based Study

The Magnitude of Dexamethasone-Induced Hyperglycemia in Cataract Surgical Patients with Normal Glucose Metabolism- A Continuous Glucose Monitoring Based Study

The magnitude of dexamethasone-induced hyperglycemia in cataract surgical patients with normal glucose metabolism: a continuous glucose monitoring based study

Continuous Glucose Monitoring: A Review of Recent Studies Demonstrating Improved Glycemic Outcomes

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