The contribution of glucose variability to asymptomatic hypoglycemia in persons with type 2 diabetes

Details

Serval ID
serval:BIB_1FF1B2BB98D3
Type
Article: article from journal or magazin.
Collection
Publications
Title
The contribution of glucose variability to asymptomatic hypoglycemia in persons with type 2 diabetes
Journal
Diabetes Technol Ther
Author(s)
Monnier L., Wojtusciszyn A., Colette C., Owens D.
ISSN
1557-8593 (Electronic)
ISSN-L
1520-9156
Publication state
Published
Issued date
08/2011
Volume
13
Number
8
Pages
813-8
Language
english
Notes
Monnier, Louis
Wojtusciszyn, Anne
Colette, Claude
Owens, David
eng
Research Support, Non-U.S. Gov't
Diabetes Technol Ther. 2011 Aug;13(8):813-8. doi: 10.1089/dia.2011.0049. Epub 2011 May 11.
Abstract
BACKGROUND: The present study was designed to define the relative contributions of glucose variability and ambient glycemia to the incidence of asymptomatic hypoglycemia in type 2 diabetes. METHODS: Two hundred twenty-two persons with type 2 diabetes were divided into three groups: Group I (n = 53) on insulin sensitizers alone, Group II (n = 87) on oral hypoglycemic agents (OHAs) to include at least one insulin secretagogue, and Group III (n = 82) on insulin alone or in combination with OHAs. Ambient mean glucose concentration (MG) values (in mmol/L) and glycemic variability (SD around the mean glucose value) (in mmol/L) or mean amplitude of glycemic excursions (in mmol/L) were assessed by a continuous glucose monitoring system. Asymptomatic hypoglycemia was recorded over a 48-h period. Poisson regression analysis was used for assessing the potential predictors of hypoglycaemia. RESULTS: The best model fit was obtained with the two following explanatory variables: MG and SD. Hypoglycemia frequency was negatively associated with MG and positively with SD: Log (number of hypoglycemia episodes) = 1.37 - (0.72 x MG) + (1.33 x SD). Odds ratios (95% confidence interval) for hypoglycemic risk were significantly different from 1 for MG at 0.96 (0.95-0.97) (P < 0.0001) and for SD at 1.08 (1.06-1.10) (P < 0.0001). In addition, the risk for hypoglycemia was completely or virtually eliminated when the SD was <1.7 mmol/L irrespective of the ambient glucose level and treatment modality. CONCLUSIONS: As the risk of asymptomatic hypoglycemia increases in the presence of increased glucose variability, avoidance of excess glucose fluctuations should be an important consideration for either reducing or preventing the risk of hypoglycemia in type 2 diabetes.
Keywords
Aged, Blood Glucose/*metabolism, Blood Glucose Self-Monitoring/methods, Cohort Studies, Diabetes Mellitus, Type 2/*blood/drug therapy, Female, Glycated Hemoglobin A/metabolism, Humans, Hypoglycemia/*blood, Hypoglycemic Agents/therapeutic use, Incidence, Male, Middle Aged, Multivariate Analysis, Regression Analysis
Pubmed
Create date
14/06/2021 8:59
Last modification date
18/09/2021 5:38
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