Continuous glucose monitoring in patients with insulinoma

Munir, Alia; Choudhary, Pratik; Harrison, Barney; Heller, Simon; Newell‐Price, John

doi:10.1111/j.1365-2265.2007.03161.x

Cited by 41 publications

(29 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[8][9][10] CGM for Guiding Diabetes Management CGM systems can be used blinded or open. When we are using CGM short-term to identify trends, such as postprandial glucose peaks, hypoglycemia, and dawn phenomenon, it is often cleaner to use blinded CGM where data are not displayed to the patient and therefore cannot be used to influence the readings.…”

Section: (5) Diagnosismentioning

confidence: 99%

Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes

Slattery

Choudhary

2017

Diabetes Technology & Therapeutics

Self Cite

View full text Add to dashboard Cite

With the emphasis on intensive management of type 1 diabetes, data from studies support frequent monitoring of glucose levels to improve glycemic control and reduce glucose variability, which can be related to an increase in macro and microvascular complications. However, few perform capillary blood glucose that frequently. There are currently two available alternatives that this review will discuss, continuous glucose monitoring (CGM) and flash glucose monitoring. CGM has become an important diagnostic and therapeutic option in optimizing diabetes management. CGM systems are now more accurate, smaller, and easier to use compared to original models. Randomized controlled trials (RCTs) have demonstrated that CGM can improve Hemoglobin A1c (HbA1C) and reduce glucose variability in both continuous subcutaneous insulin infusion and multiple daily injection users. When used in an automated ''insulin-suspend'' system, reduced frequency of hypoglycemia and shorter time spent in hypoglycemic range have been demonstrated. Despite the potential benefits CGM has to offer in clinical practice, concerns exist on the accuracy of these devices and patient compliance with therapy, which may prevent the true clinical benefit of CGM being achieved, as observed in RCTs. Flash glucose monitoring systems FreeStyle Ò LibreÔ (Abbott Diabetes Care, Alameda, CA) are as accurate as many CGM systems available and have the added benefit of being factory calibrated. Studies have shown that flash glucose monitoring systems are very well tolerated by patients and effectively reduce glucose variability, increasing time in range.

show abstract

Section: (5) Diagnosismentioning

confidence: 99%

Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes

Slattery

Choudhary

2017

Diabetes Technology & Therapeutics

Self Cite

View full text Add to dashboard Cite

show abstract

“…Ambulatory glucose profiles have been described for subjects with normal glucose tolerance, demonstrating changes in glucose over time, 27 and CGM has been used to demonstrate abnormal glucose profiles in insulinoma, cystic fibrosis, and bariatric surgery, among others. [28][29][30] Here, we describe normative reference ranges for all of the described methods of variability assessment in subjects without diabetes from varying ethnic origins.…”

mentioning

confidence: 99%

Normal Reference Range for Mean Tissue Glucose and Glycemic Variability Derived from Continuous Glucose Monitoring for Subjects Without Diabetes in Different Ethnic Groups

Hill

Oliver

Choudhary

et al. 2011

Diabetes Technology & Therapeutics

Self Cite

305

258

View full text Add to dashboard Cite

Background: Glycemic variability has been proposed as a contributing factor in the development of diabetes complications. Multiple measures exist to calculate the magnitude of glycemic variability, but normative ranges for subjects without diabetes have not been described. For treatment targets and clinical research we present normative ranges for published measures of glycemic variability. Methods: Seventy-eight subjects without diabetes having a fasting plasma glucose of < 120 mg/dL (6.7 mmol/L) underwent up to 72 h of continuous glucose monitoring (CGM) with a Medtronic Minimed (Northridge, CA) CGMS Ò Gold device. Glycemic variability was calculated using EasyGV ª software (available free for noncommercial use at www.easygv.co.uk), a custom program that calculates the SD, M-value, mean amplitude of glycemic excursions (MAGE), average daily risk ratio (ADRR), Lability Index (LI), J-Index, Low Blood Glucose Index (LBGI), High Blood Glucose Index (HBGI), continuous overlapping net glycemic action (CONGA), mean of daily differences (MODD), Glycemic Risk Assessment in Diabetes Equation (GRADE), and mean absolute glucose (MAG). Results: Eight CGM traces were excluded because there were inadequate data. From the remaining 70 traces, normative reference ranges (mean -2 SD) for glycemic variability were calculated: SD, 0-3.0; CONGA, 3.6-5.5; LI, LBGI, HBGI, GRADE, MODD, ADDR, and MAG,. Conclusions: We present normative ranges for measures of glycemic variability in adult subjects without diabetes for use in clinical care and academic research.

show abstract

“…Continuous glucose monitoring (CGM) is a valuable and useful tool in the management of diabetic patients as its use improves clinical outcomes . Continuous glucose monitoring also appears useful in screening hypoglycaemia in patients with insulinoma …”

Section: Introductionmentioning

confidence: 99%

Medical therapy in patients with endogenous hypoglycaemia: Is euglycaemia achievable?

Vezzosi

Guillaume

Bennet

et al. 2019

Clinical Endocrinology

View full text Add to dashboard Cite

Summary Context While the only curative treatment for patients with endogenous hypoglycaemia related to inappropriate insulin or to insulin growth factor 2 (IGF2) secretion is surgery, medical treatment to normalize plasma glucose levels can be useful. Objective The aim of this prospective single centre study was to assess whether patients with endogenous hypoglycaemia, considered euglycaemic with medical treatments, experienced asymptomatic hypo‐ or hyperglycaemic excursions. Patients and Methods All patients with endogenous hypoglycaemia related to inappropriate insulin or to IGF2 secretion between 2012 and 2016 and considered normoglycaemic with medical treatment (absence of clinical hypoglycaemia and self‐monitoring blood glucose in the normal range) were enroled and underwent a six‐day continuous glucose monitoring (CGM) recording. Results Twenty‐seven patients (inappropriate insulin secretion n = 25 and IGF2 secretion n = 2), treated with diazoxide (n = 16), somatostatin analogues (n = 7), glucocorticoids (n = 3) or a combination of these treatments (n = 1) were enroled. Twenty‐five CGMs were analysed. CGM confirmed normoglycaemia in 11/25 patients (44%). Hypoglycaemias below 0.60 g/L were present in seven patients (28%) and were associated with hyperglycaemic excursions above 1.40 g/L in five patients. Seven patients (28%) had only hyperglycaemic excursions. Based on these results, treatment was modified in 14 patients (56%). Conclusion Despite the disappearance of hypoglycaemia‐related clinical symptoms and normalization of blood glucose self‐monitoring data, 56% of the patients with endogenous hypoglycaemia treated with medical therapy experienced asymptomatic hypo‐ and/or hyperglycaemia. Continuous glucose monitoring could be a useful approach to reveal and prevent hypo‐ or hyperglycaemic excursions.

show abstract

Continuous glucose monitoring in patients with insulinoma

Abstract: CGM in insulinoma is useful in detecting hypoglycaemia, and hypoglycaemia unawareness, monitoring response to medical therapy and for confirming cure postoperatively, and is useful in the management of this uncommon but dangerous condition.

Cited by 41 publications

References 41 publications

Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes

Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes

Normal Reference Range for Mean Tissue Glucose and Glycemic Variability Derived from Continuous Glucose Monitoring for Subjects Without Diabetes in Different Ethnic Groups

Medical therapy in patients with endogenous hypoglycaemia: Is euglycaemia achievable?

Contact Info

Product

Resources

About