Glycemic load, exercise, and monitoring blood glucose (GEM): A paradigm shift in the treatment of type 2 diabetes mellitus

Cox, Daniel J.; Taylor, Ann Gill; Singh, Harsimran; Moncrief, Matthew; Diamond, Anne; Yancy, William S.; Hegde, Shefali; McCall, Anthony L.

doi:10.1016/j.diabres.2015.10.021

Cited by 24 publications

(31 citation statements)

References 21 publications

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“…An increase in absolute step counts (8,400–13,000 steps/per day) occurred after a 12‐week lifestyle intervention combined with RT‐CGM. A similar magnitude of change was reported in a separate study carried out in a different cohort following the same lifestyle program combined with SMBGL.…”

Section: Resultssupporting

confidence: 74%

“…A 12‐week lifestyle program combined with RT‐CGM lowered the diabetes distress score. However, similar improvements were achieved with the same lifestyle program combined with SMBGL.…”

Section: Resultsmentioning

confidence: 64%

“…A 12‐week lifestyle program combined with RT‐CGM produced an average 1.1% HbA1c reduction in six participants. The authors compared these data with findings from a separate, independent 12‐week intervention ( n = 47) that used the same lifestyle program with SMBGL and reported similar HbA1c reductions (1%). However, population size heterogeneity between the two datasets carried out over different time‐periods limits the ability to draw effective comparisons.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

Taylor

Thompson

Brinkworth

2018

J of Diabetes Invest

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The present narrative review discusses the role of continuous glucose monitoring (CGM) in glycemic and weight control, and lifestyle behavior adherence in adults with type 2 diabetes. A literature search from January 2001 to November 2017 was carried out (MEDLINE, CINAHL, Web of Science and Scopus). Eligible studies were trials evaluating the use of CGM with the aim of achieving glucose control or lifestyle‐related treatment adherence over a period of ≥8 weeks in adults with type 2 diabetes compared with usual care or another comparison intervention, or observational trials reporting CGM user experience. A total of 5,542 participants were recruited into 11 studies (eight randomized controlled trials [n = 5,346] and three observational studies [n = 196]). The sample size ranged 6–4,678 participants, the mean age was 51.7–60.0 years and diabetes duration was 2.1–19.2 years, with high heterogeneity between studies. Overall, the available evidence showed, compared with traditional self‐monitoring of blood glucose levels, CGM promoted greater reductions in glycated hemoglobin, bodyweight and caloric intake; higher adherence rating to a personal eating plan; and increases in physical activity. High compliance to CGM wear‐time and device calibration was reported (>90%). The addition of lifestyle and/or behavioral counseling to CGM appeared to further potentiate these improvements. Preliminary evidence suggests that CGM use promotes glycemic and weight control, and lifestyle behavior adherence in adults with type 2 diabetes. These benefits might be further enhanced with integration of diet, exercise, and glucose excursion education and counseling. However, specific attributes of effective interventions and the application of CGM information for promoting improved outcomes and healthier choices remain unclear.

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Section: Resultssupporting

confidence: 74%

“…A 12‐week lifestyle program combined with RT‐CGM lowered the diabetes distress score. However, similar improvements were achieved with the same lifestyle program combined with SMBGL.…”

Section: Resultsmentioning

confidence: 64%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

Taylor

Thompson

Brinkworth

2018

J of Diabetes Invest

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“…In a preliminary study, GEM effectively lowered HbA 1c and promoted positive but not negative side effects (3). Despite the potential benefits of systematic SMBG to educate, activate, and motivate positive choices, GEM subjects in the preliminary study (3) did not perform more SMBG than subjects undergoing routine care, despite receiving free SMBG supplies.…”

mentioning

confidence: 99%

“…Two dropped out because of psychiatric issues. Participants read five GEM manual chapters at home and then discussed their relevance to their daily routine during each of five group sessions (see preliminary study for details [3]). Participants were assessed at baseline and at 3-month follow-up.…”

mentioning

confidence: 99%

Continuous Glucose Monitoring in the Self-management of Type 2 Diabetes: A Paradigm Shift

et al. 2016

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Behavioral Strategies to Lower Postprandial Glucose in Those with Type 2 Diabetes May Also Lower Risk of Coronary Heart Disease

et al. 2018

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IntroductionEfforts to lower glycosylated hemoglobin (A1c) in patients with type 2 diabetes (T2D) are intended to reduce the risk of diabetic complications, but A1c is not the only factor contributing to this risk. Consequently, we re-analyzed published data from a broad-spectrum lifestyle intervention that lowered A1c to assess its effectiveness in lowering the overall risk of two complications of T2D, namely, coronary heart disease (CHD) and stroke.MethodsData from 37 adults who participated in a randomized clinical trial of a lifestyle intervention intended to reduce postprandial glucose (PPG) were re-analyzed for their pre- and post-treatment risk of CHD and stroke using the T2D-specific UK Prospective Diabetes Study (UKPDS) v2.0 risk algorithm.ResultsCompared to participants who received routine care, those using the lifestyle intervention had a significantly greater reduction in 10-year risk for CHD, but not for stroke.ConclusionThese secondary analyses suggest that broad-spectrum lifestyle interventions that focus on lowering PPG may lower the risk of future CHD, which could guide future research.Trial RegistrationClinicalTrials.gov ID: NCT02432391.

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Glycemic load, exercise, and monitoring blood glucose (GEM): A paradigm shift in the treatment of type 2 diabetes mellitus

Cited by 24 publications

References 21 publications

Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

Continuous Glucose Monitoring in the Self-management of Type 2 Diabetes: A Paradigm Shift

Behavioral Strategies to Lower Postprandial Glucose in Those with Type 2 Diabetes May Also Lower Risk of Coronary Heart Disease

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