دورية أكاديمية
Continuous glucose monitoring in people with type 1 diabetes on multiple-dose injection therapy: the relationship between glycemic control and hypoglycemia
| العنوان: | Continuous glucose monitoring in people with type 1 diabetes on multiple-dose injection therapy: the relationship between glycemic control and hypoglycemia |
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| المؤلفون: | Oliver, N, Gimenez, M, Calhoun, P, Cohen, N, Moscardo, V, Hermanns, N, Freckmann, G, Reddy, M, Heinemann, L |
| المساهمون: | National Institute for Health Research, Imperial College Healthcare NHS Trust- BRC Funding |
| المصدر: | 58 ; 53 |
| بيانات النشر: | American Diabetes Association |
| سنة النشر: | 2019 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | Science & Technology, Life Sciences & Biomedicine, Endocrinology & Metabolism, DAILY INSULIN INJECTIONS, INTENSIVE TREATMENT, ADULTS, MULTICENTER, DIAMOND, Adult, Blood Glucose, Blood Glucose Self-Monitoring, Diabetes Mellitus, Type 1, Dose-Response Relationship, Drug, Female, Glycated Hemoglobin A, Humans, Hypoglycemia, Hypoglycemic Agents, Injections, Subcutaneous, Insulin, Male, Middle Aged, 11 Medical and Health Sciences |
| جغرافية الموضوع: | United States |
| الوصف: | OBJECTIVE: The inverse relationship between overall glucose control and hypoglycemia risk is weakened by the use of real-time continuous glucose monitoring (rtCGM). We assess the relationship between glucose control and hypoglycemia in people with type 1 diabetes using multiple-dose injection (MDI) regimens, including those at highest risk of hypoglycemia. RESEARCH DESIGN AND METHODS: CGM data from the intervention (rtCGM) and control (self-monitored blood glucose [SMBG]) phases of the Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes (DIAMOND) and HypoDE studies were analyzed. The relationship between glucose control (HbA1c and mean rtCGM glucose levels) and percentage time spent in hypoglycemia was explored for thresholds of 3.9 mmol/L (70 mg/dL) and 3.0 mmol/L (54 mg/dL), and ANOVA across the range of HbA1c and mean glucose was performed. RESULTS: A nonlinear relationship between mean glucose and hypoglycemia was identified at baseline, with the steepest relationship seen at lower values of mean glucose. The use of rtCGM reduces the exposure to hypoglycemia at all thresholds and flattens the relationship between overall glucose and hypoglycemia, with the most marked impact at lower values of mean glucose and HbA1c. Exposure to hypoglycemia varied at all thresholds across the range of overall glucose at baseline, in the SMBG group, and with rtCGM, but the relationships were weaker in the rtCGM group. CONCLUSIONS: Usage of rtCGM can flatten and attenuate the relationship between overall glucose control and hypoglycemia, exerting its greatest impact at lower values of HbA1c and mean glucose in people with type 1 diabetes using MDI regimens and at highest risk of hypoglycemia. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0149-5992 |
| العلاقة: | Diabetes Care; http://hdl.handle.net/10044/1/73596Test; RDA11 79560; RDA29 |
| DOI: | 10.2337/dc19-0977 |
| الإتاحة: | https://doi.org/10.2337/dc19-0977Test http://hdl.handle.net/10044/1/73596Test |
| حقوق: | © 2019 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/licenseTest. |
| رقم الانضمام: | edsbas.876FE91F |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 01495992 |
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| DOI: | 10.2337/dc19-0977 |