Prediction of nocturnal hypoglycemia unawareness by fasting glucose levels or post-breakfast glucose fluctuations in patients with type 1 diabetes receiving insulin degludec: A pilot study
| العنوان: | Prediction of nocturnal hypoglycemia unawareness by fasting glucose levels or post-breakfast glucose fluctuations in patients with type 1 diabetes receiving insulin degludec: A pilot study |
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| المؤلفون: | Hiroshi Takahashi, Kazunori Utsunomiya, Rimei Nishimura, Yoshiko Onda, Kiyotaka Ando, Daisuke Tsujino |
| المصدر: | PLoS ONE, Vol 12, Iss 7, p e0177283 (2017) PLoS ONE |
| بيانات النشر: | Public Library of Science (PLoS), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Blood Glucose, Male, Insulin degludec, medicine.medical_treatment, lcsh:Medicine, Pilot Projects, Biochemistry, Endocrinology, 0302 clinical medicine, Outpatients, Medicine and Health Sciences, Diabetes diagnosis and management, Insulin, 030212 general & internal medicine, lcsh:Science, Multidisciplinary, Organic Compounds, Pharmaceutics, Monosaccharides, Drugs, Fasting, Middle Aged, Postprandial Period, Prognosis, Insulin, Long-Acting, Chemistry, Postprandial, Area Under Curve, Physical Sciences, Female, medicine.symptom, Research Article, Adult, medicine.medical_specialty, HbA1c, Patients, Endocrine Disorders, Photoperiod, Carbohydrates, Hypoglycemics, 030209 endocrinology & metabolism, Hypoglycemia, Asymptomatic, 03 medical and health sciences, Dose Prediction Methods, Internal medicine, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, Hypoglycemic Agents, Hemoglobin, Aged, Breakfast, Glycemic, Glycated Hemoglobin, Diabetic Endocrinology, Pharmacology, Type 1 diabetes, business.industry, Organic Chemistry, lcsh:R, Chemical Compounds, Biology and Life Sciences, Proteins, medicine.disease, Hormones, Diagnostic medicine, Health Care, Diabetes Mellitus, Type 1, Glucose, Metabolic Disorders, lcsh:Q, business, Biomarkers |
| الوصف: | Objective To evaluate whether nocturnal asymptomatic hypoglycemia (NAH) can be predicted by fasting glucose levels or post-breakfast glucose fluctuations in patients with type 1 diabetes (T1D) receiving insulin degludec. Methods Patients with T1D receiving insulin degludec underwent at-home CGM assessments. Indices for glycemic variability before and after breakfast included fasting glucose levels and the range of post-breakfast glucose elevation. For comparison, the patients were classified into those with NAH and those without. The optimal cut-off values for the relevant parameters were determined to predict NAH using ROC analysis. Results The study included a total of 31 patients (mean HbA1c values, 7.8 ± 0.7%), and 16 patients (52%) had NAH. Those with NAH had significantly lower fasting glucose levels than did those without (82 ± 48 mg/dL vs. 144 ± 69 mg/dL; P = 0.009). The change from pre- to post-breakfast glucose levels was significantly greater among those with NAH (postprandial 1-h, P = 0.028; postprandial 2-h, P = 0.028). The cut-off values for prediction of NAH were as follows: fasting glucose level 69 mg/dL (0.75/0.67/0.73; P = 0.033), and 2-h postprandial elevation >99 mg/dL (0.69/0.67/0.71; P = 0.044). Conclusions The results suggest that fasting glucose level of < 84 mg/dL had approximately 80% probability of predicting the occurrence of NAH in T1D receiving insulin degludec. It was also shown that the occurrence of hypoglycemia led to greater post-breakfast glucose fluctuations and steeper post-breakfast glucose gradients. |
| اللغة: | English |
| تدمد: | 1932-6203 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2038de8aff5a7d2003ce89a7948a496eTest http://europepmc.org/articles/PMC5499999?pdf=renderTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....2038de8aff5a7d2003ce89a7948a496e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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