Characteristics of Glycemic Stability

Service, F. John; Nelson, Roger

doi:10.2337/diacare.3.1.58

Cited by 111 publications

(79 citation statements)

References 7 publications

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“…This parameter is a logarithmic transformation of the deviation of glycaemia from an arbitrarily selected value (120 mg/ dl in the original description; modified to 90 [8] to reflect true mean glycaemia in non-diabetic subjects) plus an amplitude correction factor (W/20=maximum ± minimum glucose in mg/ dl¸20); (7) mean amplitude of glycaemic excursion (MAGE) [9]: arithmetic mean of glucose nadir to peak (or vice versa) differences when each of these differences is greater than or equal to one standard deviation; (8) individual time points in the 7-point glucose collection: before breakfast, after breakfast, before lunch, after lunch, before supper, after supper and at bedtime.…”

Section: Methodsmentioning

confidence: 99%

The relation of glycaemia to the risk of development and progression of retinopathy in the Diabetic Control and Complications Trial

O’Brien

2001

Diabetologia

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The achievement of near-normal blood glucose concentrations from intensified therapy has been shown to retard the development and progression of the microvascular complications of Type I (insulin-dependent) and Type II (non-insulin-dependent) diabetes mellitus (DCCT [1] and the Kumamoto study Abstract Aims/hypothesis. We have assessed the relation between the quarterly capillary glucose profile and the risk of the development and progression of retinopathy in the DCCT. Methods. Seven point (preprandial and 90-min postprandial for each meal and bedtime) capillary glucose data were analysed from volunteers whose collections were complete in 80 %, or more, of quarterly periods and who were in the study longer than 4 years (n = 296, conventional therapy; n = 269, intensive therapy). The study cohort differed from excluded patients in having more women and lower HbA 1 c at baseline and fewer adolescents, older age and lower baseline mean blood glucose in the intensive therapy group.Results. Univariate analysis showed significant (p < 0.01) associations to sustained 3-step change in retinopathy of each updated glycaemic parameter: mean blood glucose, mean preprandial glucose, mean postprandial glucose, each preprandial, postprandial and bedtime glucose; range glucose, standard deviation glucose; M-value of Schlichtkrull and mean amplitude of glycaemic excursions, albeit with relatively small hazard ratios. Multivariate analyses showed updated mean blood glucose to be the primary risk factor (p < 0.001) with a weak contribution of mean amplitude of glycaemic excursions at baseline (p < 0.005); no other variables added significantly to the model. The association between updated mean blood glucose and risk for retinopathy was nonlinear: risk progressively increased above updated mean blood glucose of 8.3 mmol/l. A gradient of risk could not be determined below this level because events were few. Conclusion/interpretation. Within the limitations provided by quarterly 7-point capillary glucose measurements as an expression of overall glycaemic behaviour, the major risk for progression of retinopathy is conveyed by updated mean blood glucose especially above 8.3 mmol/l. [Diabetologia (2001[Diabetologia ( ) 44: 1215± 1220

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Section: Methodsmentioning

confidence: 99%

The relation of glycaemia to the risk of development and progression of retinopathy in the Diabetic Control and Complications Trial

O’Brien

2001

Diabetologia

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“…MODD represented the mean of the absolute difference between glucose values measured on two successive days, as described previously4. A high MODD value represents a major difference in day‐to‐day glycemic profile.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing inter‐day glycemic variability in diabetic outpatients receiving insulin therapy

Mori

Okada

Kurozumi

et al. 2016

J of Diabetes Invest

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IntroductionThe aim of the present study was to determine the actual state of inter‐day glycemic variability and identify the factors that affect glycemic variability in diabetic outpatients on insulin therapy.Materials and MethodsThe participants were 45 outpatients with diabetes mellitus receiving insulin therapy. The mean plasma glucose (MPG) levels, intra‐day glycemic variability (expressed by standard deviation and mean amplitude of glucose excursion) and inter‐day glycemic variability (expressed by mean of daily differences [MODD] in blood glucose levels) were measured continuously over 7 days with iPro2®. The primary outcome was the relationship between MODD and the life variability index.Results MODD values were high in 93.3% of the participants, and significantly higher in patients with lifestyle changes than in those without (higher in patients with high life variability index). MODD values were not associated with age, but significantly higher in women. MODD values correlated significantly with glycated hemoglobin and glycoalbumin levels, and negatively with 1,5‐anhydroglucitol levels. MODD values were significantly higher in type 1 diabetes patients and not associated with duration of disease. MODD values correlated significantly with insulin dose. Multivariate analysis identified the life variability index as a significant determinant of MODD.ConclusionsiPro2® provided detailed information on glycemic profile in diabetic outpatients receiving insulin therapy. The results suggest that patients with large inter‐day glycemic variability are unlikely to achieve an improvement in their glycated hemoglobin level. Treatment and instructions based on a patient's characteristics, day‐to‐day glycemic variability and lifestyle are important to achieve good glycemic control.

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“…FPG levels were titrated using the same algorithm and stabilized at 80 mg/dL level with Glargine 300 during washing out. Data collected on the second day of measurement (mean amplitude of glycemic excursion (MAGE) [15], mean of daily differences (MODD) [16], average daily risk range (ADRR) [17]: all days of measurement) were analyzed. Regarding other diabetic treatments, sulfonylurea agents, α-glucosidase inhibitors, rapid-acting insulin secretagogues, and glucagon-like peptide-1 receptor agonists were discontinued after enrollment.…”

Section: Outcomes and Statistical Analysismentioning

confidence: 99%

Comparison of tofogliflozin 20 mg and ipragliflozin 50 mg used together with insulin glargine 300 U/mL using continuous glucose monitoring (CGM): A randomized crossover study

2017

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Characteristics of Glycemic Stability

Cited by 111 publications

References 7 publications

The relation of glycaemia to the risk of development and progression of retinopathy in the Diabetic Control and Complications Trial

The relation of glycaemia to the risk of development and progression of retinopathy in the Diabetic Control and Complications Trial

Factors influencing inter‐day glycemic variability in diabetic outpatients receiving insulin therapy

Comparison of tofogliflozin 20 mg and ipragliflozin 50 mg used together with insulin glargine 300 U/mL using continuous glucose monitoring (CGM): A randomized crossover study

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