Toward Defining the Threshold Between Low and High Glucose Variability in Diabetes.
Details
Serval ID
serval:BIB_819F459AE3EF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Toward Defining the Threshold Between Low and High Glucose Variability in Diabetes.
Journal
Diabetes care
ISSN
1935-5548 (Electronic)
ISSN-L
0149-5992
Publication state
Published
Issued date
07/2017
Peer-reviewed
Oui
Volume
40
Number
7
Pages
832-838
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
To define the threshold for excess glucose variability (GV), one of the main features of dysglycemia in diabetes.
A total of 376 persons with diabetes investigated at the University Hospital of Montpellier (Montpellier, France) underwent continuous glucose monitoring. Participants with type 2 diabetes were divided into several groups-groups 1, 2a, 2b, and 3 (n = 82, 28, 65, and 79, respectively)-according to treatment: 1) diet and/or insulin sensitizers alone; 2) oral therapy including an insulinotropic agent, dipeptidyl peptidase 4 inhibitors (group 2a) or sulfonylureas (group 2b); or 3) insulin. Group 4 included 122 persons with type 1 diabetes. Percentage coefficient of variation for glucose (%CV = [(SD of glucose)/(mean glucose)] × 100) and frequencies of hypoglycemia (interstitial glucose <56 mg/dL [3.1 mmol/L]) were computed.
Percentages of CV (median [interquartile range]; %) increased significantly (P < 0.0001) from group 1 (18.1 [15.2-23.9]) to group 4 (37.2 [31.0-42.3]). In group 1, the upper limit of %CV, which served as reference for defining excess GV, was 36%. Percentages of patients with %CVs above this threshold in groups 2a, 2b, 3, and 4 were 0, 12.3, 19.0, and 55.7%, respectively. Hypoglycemia was more frequent in group 2b (P < 0.01) and groups 3 and 4 (P < 0.0001) when subjects with a %CV >36% were compared with those with %CV ≤36%.
A %CV of 36% appears to be a suitable threshold to distinguish between stable and unstable glycemia in diabetes because beyond this limit, the frequency of hypoglycemia is significantly increased, especially in insulin-treated subjects.
A total of 376 persons with diabetes investigated at the University Hospital of Montpellier (Montpellier, France) underwent continuous glucose monitoring. Participants with type 2 diabetes were divided into several groups-groups 1, 2a, 2b, and 3 (n = 82, 28, 65, and 79, respectively)-according to treatment: 1) diet and/or insulin sensitizers alone; 2) oral therapy including an insulinotropic agent, dipeptidyl peptidase 4 inhibitors (group 2a) or sulfonylureas (group 2b); or 3) insulin. Group 4 included 122 persons with type 1 diabetes. Percentage coefficient of variation for glucose (%CV = [(SD of glucose)/(mean glucose)] × 100) and frequencies of hypoglycemia (interstitial glucose <56 mg/dL [3.1 mmol/L]) were computed.
Percentages of CV (median [interquartile range]; %) increased significantly (P < 0.0001) from group 1 (18.1 [15.2-23.9]) to group 4 (37.2 [31.0-42.3]). In group 1, the upper limit of %CV, which served as reference for defining excess GV, was 36%. Percentages of patients with %CVs above this threshold in groups 2a, 2b, 3, and 4 were 0, 12.3, 19.0, and 55.7%, respectively. Hypoglycemia was more frequent in group 2b (P < 0.01) and groups 3 and 4 (P < 0.0001) when subjects with a %CV >36% were compared with those with %CV ≤36%.
A %CV of 36% appears to be a suitable threshold to distinguish between stable and unstable glycemia in diabetes because beyond this limit, the frequency of hypoglycemia is significantly increased, especially in insulin-treated subjects.
Keywords
Aged, Blood Glucose, Diabetes Mellitus, Type 1/blood, Diabetes Mellitus, Type 1/drug therapy, Diabetes Mellitus, Type 2/blood, Diabetes Mellitus, Type 2/drug therapy, Dipeptidyl-Peptidase IV Inhibitors/pharmacology, Dipeptidyl-Peptidase IV Inhibitors/therapeutic use, Female, Humans, Hypoglycemia/blood, Hypoglycemia/drug therapy, Hypoglycemic Agents/pharmacology, Hypoglycemic Agents/therapeutic use, Insulin/pharmacology, Insulin/therapeutic use, Male, Middle Aged, Sulfonylurea Compounds/pharmacology, Sulfonylurea Compounds/therapeutic use, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
14/06/2021 9:59
Last modification date
24/05/2024 13:41