Characterizing Blood Glucose Variability Using New Metrics with Continuous Glucose Monitoring Data

Abstract

We have developed a new automated metric to assess overall glycemic variability in people with diabetes using CGM, which could easily be incorporated into commercially available CGM software. Additional work to validate and refine this metric is underway. Future studies are planned to correlate the metric with both urinary 8-iso-prostaglandin F2 alpha excretion and serum 1,5-anhydroglucitol levels to see how well it identifies patients with high glycemic variability and increased markers of oxidative stress to assess risk for long-term complications of diabetes.

Teneligliptin: Heralding Change in Type 2 Diabetes

“…It includes only peak-to-nadir or nadir-to-peak excursions in its calculation, depending on which type of excursion occurs first in the day's data. [16] GA is a better marker than HbA1c for short term variations of glycemic control. HbA1c predicts glycemia over 2-3 months; GA predicts glycemia over 2 -3 weeks [17].…”

Teneligliptin improves glycemic control with the reduction of postprandial insulin requirement in Japanese diabetic patients

“…Administration of teneligliptin (20 mg/day, once daily before breakfast) started on the eighth day and continued for 3 consecutive days. In CGM, mean and standard deviation (SD) of 24-h blood glucose level, mean amplitude of glycemic excursions (MAGE) [11], and proportion of time in hyperglycemia (> 180 mg/dL) or hypoglycemia (< 70 mg/dL) were calculated. Meal tolerance tests (592 kcal, carbohydrate 75 g, protein 8.0 g, fat 28.5 g, Saraya Corp, Osaka, Japan) [12] were conducted on the seventh day (before the initiation of teneligliptin treatment) and the tenth day (3 days after starting teneligliptin).…”

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“…The mean amplitude of glycemic excursion (MAGE), glycoalbumin, and 1.5-anhydroglucitol measurements are usually used in evaluation of the glycemic variability (6)(7)(8). The MAGE level is calculated as the arithmetic mean of the elevations and reductions in blood glucose levels (9)(10)(11) and is reported to be a more sensitive method than HbA1c in evaluation of the glycemic variability (6,12,13).…”