Toward Defining the Threshold Between Low and High Glucose Variability in Diabetes
Details
Serval ID
serval:BIB_9300B538BB88
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
0149-5992
Publication state
Published
Issued date
2017
Volume
40
Number
7
Pages
832-838
Language
english
Notes
Ey2ec
Times Cited:119
Cited References Count:34
Times Cited:119
Cited References Count:34
Abstract
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)] 3 100) 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 oe 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.
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)] 3 100) 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 oe 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.
Keywords
silent myocardial-infarction, cardiovascular outcomes, heart-failure, double-blind, type-2, liraglutide, empagliflozin, risk, disease, intervention
Web of science
Create date
14/06/2021 9:59
Last modification date
18/09/2021 6:38