High Incidence of Hypoglycemia in Stable Insulin-Treated Type 2 Diabetes Mellitus: Continuous Glucose Monitoring vs. Self-Monitored Blood Glucose. Observational Prospective Study

Pazos-Couselo, Marcos; García-López, José Manuel; González-Rodríguez, María; Mayán-Santos, Jose Manuel; Rodrı́guez-Garcı́a, Javier; Casanueva, Felipe F.

doi:10.1016/j.jcjd.2015.05.007

Cited by 34 publications

(25 citation statements)

References 23 publications

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“…Previous studies with CGM showed that hypoglycemia occurred more frequently during the night than during the daytime in insulin‐treated patients with type 1 or type 2 diabetes. In contrast, daytime hypoglycemic events were more frequent than nocturnal hypoglycemic events in a study based on self‐reporting of such events.…”

Section: Discussionmentioning

confidence: 74%

Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross‐sectional study

Matsuoka

Hirota

Takeda

et al. 2019

J of Diabetes Invest

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Aims/Introduction Sulfonylurea‐related hypoglycemia increases the risk of cardiovascular sequela, such as cardiac arrhythmia. This study aimed to clarify the relationship between the level of glycated hemoglobin (HbA1c) and the duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas. Materials and Methods Glucose levels in the enrolled patients (n = 300) were investigated with a professional continuous glucose monitoring device in the outpatient setting at six diabetes centers in Japan. Results A total of 269 participants completed the study. The duration of hypoglycemia with glucose values of <54 mg/dL was significantly longer in patients with an HbA1c level of ≤6.4% than in those with an HbA1c level of ≥8.0%, and that of hypoglycemia with glucose values of <70 mg/dL was significantly longer in patients with an HbA1c level of ≤6.4%, 6.5–6.9% or 7.0–7.4% than in those with an HbA1c level of ≥8.0%. Patients with an HbA1c level of ≤6.4% were exposed to glucose values of <70 mg/dL for >10% of the time in daily life (6.8 ± 5.6 min/h). The duration of hypoglycemia with glucose values of <70 mg/dL was longer at night than during the daytime, and the nadir of glucose values occurred between 03.00 and 05.00 hours irrespective of HbA1c level. The duration of hypoglycemia was associated with the duration of diabetes and sulfonylurea dose. Conclusions The duration of hypoglycemia was inversely correlated with HbA1c level and was longer during the night‐time than daytime in type 2 diabetes patients treated with sulfonylureas.

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Section: Discussionmentioning

confidence: 74%

Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross‐sectional study

Matsuoka

Hirota

Takeda

et al. 2019

J of Diabetes Invest

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“…17 More hypoglycemia was seen with CGM than by SMBG (79.2 episodes/patient/ year vs. 16.6 episodes/patient/year). Moreover, 36% of hypoglycemic events detected by CGM were nocturnal, and 19% of patients had hypoglycemia detected by CGM but without any hypoglycemia by SMBG measurements.…”

Section: Studies Of Hypoglycemiamentioning

confidence: 95%

“…16 Pazos-Couselo et al in 2015 completed an observational, prospective study of 63 patients with T2D on insulin (basal only, premixed or basal/bolus, average age 62.7 years). 17 Patients were on a stable regimen (no significant dose adjustments in the prior 2 months) and were asked to complete two SMBG readings (pre-and post-meal) per day, rotating from breakfast, lunch, and dinner every day for 8 weeks. During the ninth week, they wore blinded CGM.…”

Section: Studies Of Hypoglycemiamentioning

confidence: 99%

Clinical Use of Continuous Glucose Monitoring in Adults with Type 2 Diabetes

Carlson¹,

Mullen²,

Bergenstal³

2017

Diabetes Technology & Therapeutics

124

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Background: Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions.CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D). Several diabetes organizations have recently reviewed the literature on the appropriate use of CGM in diabetes management and concluded CGM may be a useful educational and management tool particularly for patients on insulin therapy. The indications for using CGM either as a clinic-based loaner distribution model for intermittent use (professional CGM) or a CGM system owned by the patient and used at home with real-time glucose reading (personal CGM) are only beginning to be addressed in T2D. Most summaries of CGM studies conclude that having a standardized glucose pattern report, such as the ambulatory glucose profile (AGP) report, should help facilitate effective shared decision-making sessions.The future of CGM indications for the use of CGM is evolving rapidly. In some instances, CGM is now approved for making medication adjustments without SMBG confirmation and it appears that some forms of CGM will be approved for use in the Medicare population in the United States in the near future. Many individuals with T1D and T2D and their care teams will come to depend on CGM as a key tool for diabetes management.

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“…57 Finally, Pazos-Couselo et al evaluated 63 insulin-treated patients with type 2 diabetes and showed that CGM over 1 week identified more hypoglycemia than was found on 8 weeks of monitoring with SMBG. 60 Fifty-nine percent of the patients had hypoglycemia by CGM and 30% had nocturnal hypoglycemia. Likewise, the UKPDS data confirmed the increased frequency of hypoglycemia among those with type 2 diabetes who were treated with MDI relative to basal insulin or noninsulin therapy.…”

Section: Evidence For General Benefit Of Cgm In Type 2 Diabetesmentioning

confidence: 95%

Continuous Glucose Monitoring with Multiple Daily Insulin Treatment: Outcome Studies

McGill

Ahmann

2017

Diabetes Technology & Therapeutics

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Continuous glucose monitoring (CGM) is developing into an increasingly useful tool for glucose monitoring and therapeutic guidance in the treatment of diabetes. Multiple daily doses of insulin (MDI) is the most common method for intensive insulin treatment of type 1 diabetes and is also becoming more common in the treatment of type 2 diabetes as an increasing population with type 2 diabetes experiences progressive beta cell loss. The clinical evidence demonstrating the benefit of CGM in the outcomes of patients treated with MDI is becoming clearer, particularly with the recent completion of several randomized clinical trials addressing both type 1 and 2 diabetes. This evidence is reviewed.

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High Incidence of Hypoglycemia in Stable Insulin-Treated Type 2 Diabetes Mellitus: Continuous Glucose Monitoring vs. Self-Monitored Blood Glucose. Observational Prospective Study

Cited by 34 publications

References 23 publications

Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross‐sectional study

Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross‐sectional study

Clinical Use of Continuous Glucose Monitoring in Adults with Type 2 Diabetes

Continuous Glucose Monitoring with Multiple Daily Insulin Treatment: Outcome Studies

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