Flash glucose monitoring system in special situations

Abstract

The management of diabetes mellitus (DM) requires maintaining glycemic control, and patients must keep their blood glucose levels close to the normal range to reduce the risk of microvascular complications and cardiovascular events. While glycated hemoglobin (A1C) is currently the primary measure for glucose management and a key marker for long-term complications, it does not provide information on acute glycemic excursions and overall glycemic variability. These limitations may even be higher in some special situations, thereby compromising A1C accuracy, especially when wider glycemic variability is expected and/or when the glycemic goal is more stringent. To attain adequate glycemic control, continuous glucose monitoring (CGM) is more useful than self-monitoring of blood glucose (SMBG), as it is more convenient and provides a greater amount of data. Flash Glucose Monitoring (isCGM /FGM) is a widely accepted option of CGM for measuring interstitial glucose levels in individuals with DM. However, its application under special conditions, such as pregnancy, patients on hemodialysis, patients with cirrhosis, during hospitalization in the intensive care unit and during physical exercise has not yet been fully validated. This review addresses some of these specific situations in which hypoglycemia should be avoided, or in pregnancy, where strict glycemic control is essential, and the application of isCGM/FGM could alleviate the shortcomings associated with poor glucose control or high glycemic variability, thereby contributing to high-quality care.

Evaluation of Antidiabetic Activity of Oxadiazole Derivative in Rats

“…Treatment with the 1,3,4-oxadiazole derivative, however, represented a significant gain in body weight as compared to the disease control group. Glycated hemoglobin is an extensively accepted parameter for the identification of plasma glycemic levels in a diabetic patient [ 32 ]. Protein glycation involves a series of complex reactions that occur between monosaccharides (glucose and fructose) and amino acids or proteins, producing an unstable Schiff base and then forming Amadori products such as fructosamine [ 33 ].…”

Advanced Glycation End Products and Their Effect on Vascular Complications in Type 2 Diabetes Mellitus

“…HbA1c, which is generated from the nonenzymatic glycation of hemoglobin, is the well-established standard for assessing glycemic management, and links between higher HbA1c and diabetic complications have been shown [ 15 , 16 ]. Because the mean HbA1c provides incomplete information about glycemic variability, long-term glycemic exposure, and fundamental causes of diabetic complications, markers of complications that account for the duration of hyperglycemia have been investigated [ 17 ]. Thus, the limitations of HbA1c lead to a focus on complementary methods for predicting diabetic complications [ 18 ].…”