Toward Defining the Threshold Between Low and High Glucose Variability in Diabetes

Détails

ID Serval
serval:BIB_819F459AE3EF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Toward Defining the Threshold Between Low and High Glucose Variability in Diabetes
Périodique
Diabetes Care
Auteur⸱e⸱s
Monnier L., Colette C., Wojtusciszyn A., Dejager S., Renard E., Molinari N., Owens D. R.
ISSN
1935-5548 (Electronic)
ISSN-L
0149-5992
Statut éditorial
Publié
Date de publication
07/2017
Volume
40
Numéro
7
Pages
832-838
Langue
anglais
Notes
Monnier, Louis
Colette, Claude
Wojtusciszyn, Anne
Dejager, Sylvie
Renard, Eric
Molinari, Nicolas
Owens, David R
eng
Diabetes Care. 2017 Jul;40(7):832-838. doi: 10.2337/dc16-1769. Epub 2016 Dec 30.
Résumé
OBJECTIVE: To define the threshold for excess glucose variability (GV), one of the main features of dysglycemia in diabetes. RESEARCH DESIGN AND METHODS: 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)] x 100) and frequencies of hypoglycemia (interstitial glucose <56 mg/dL [3.1 mmol/L]) were computed. RESULTS: 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%. CONCLUSIONS: 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.
Mots-clé
Aged, *Blood Glucose, Diabetes Mellitus, Type 1/*blood/drug therapy, Diabetes Mellitus, Type 2/*blood/drug therapy, Dipeptidyl-Peptidase IV Inhibitors/pharmacology/therapeutic use, Female, Humans, Hypoglycemia/blood/drug therapy, Hypoglycemic Agents/*pharmacology/therapeutic use, Insulin/pharmacology/therapeutic use, Male, Middle Aged, Sulfonylurea Compounds/*pharmacology/therapeutic use, Treatment Outcome
Pubmed
Création de la notice
14/06/2021 9:59
Dernière modification de la notice
18/09/2021 6:38
Données d'usage