Home blood glucose concentrations in maturity-onset diabetes.

Abstract

Blood glucose concentrations during normal daily activities were measured in 106 patients with maturityonset diabetes from capillary blood samples collected on to filter paper. Samples were taken before and two hours after main meals, before going to bed, and, in 51 cases, during the night. Fasting and mid-morning values were closely correlated with the mean values over 24 hours irrespective of the type of anti-diabetic treatment being given. Postprandial blood glucose concentrations remained below 11 5 mmol/l (207 mg/100 ml) when the fasting blood glucose value was 7 0 mmol/l (126 mg/100 ml) or less, and repeated fasting blood glucose values exceeding 7-0 mmol/l were associated with raised blood glycosylated haemoglobin concentrations. Diabetic control in maturity-onset diabetes may be satisfactorily monitored by regular measurement of fasting or mid-morning blood glucose values.

Nonfasting Plasma Glucose is a Better Marker of Diabetic Control Than Fasting Plasma Glucose in Type 2 Diabetes

“…Moreover, most of the patients in the study by Gonen et al were treated with insulin, whereas none of our patients were treated with insulin. In another study of non-insulin-treated type 2 diabetic patients, Paisey et al (18) found a correlation coefficient of 0.86 by averaging at least three fasting capillary blood glucose measurements obtained over several weeks and testing their relationship with the WoK\ percentages evaluated at the end of the test period. The correlation is similar to that observed in our study between HbA lc and a single ambulatory measurement of either postlunch PG (r = 0.81) or extended postlunch PG(r = 0.78).…”

The relationship between fasting plasma glucose and HbA1c during intensive periods of glucose control in antidiabetic therapy

“…Both, theoretical considerations based on the slow timescales of glycation of hemoglobin as well as experimental studies have showed that FPG-HbA 1c correlations are best effective in those circumstances when average glucose changes relatively slowly compared to the timescale of HbA 1c equilibration (Paisey et al, 1980;Bouma et al, 1999). In other words, when diabetic patients are placed on antidiabetic therapy glucose changes continuously and HbA 1c cannot be expected to be in a good equilibrium relative to FPG, especially at the start of treatment.…”

“…Derr et al (2003) investigated the effects of glycemic variation and mean blood glucose (MBG) on HbA 1c in type 1 and type 2 diabetic patients to show that HbA 1c is a linear predictor of MBG over the previous 90 days. The steadystate relationship between FPG and HbA 1c has been investigated extensively in type 2 diabetic patients (Paisey et al, 1980;Avignon et al, 1997;Bouma et al, 1999). Paisey et al (1980) have shown that a mean of at least three fasting capillary blood glucose have good correlation with HbA 1c (n ¼106).…”

“…The steadystate relationship between FPG and HbA 1c has been investigated extensively in type 2 diabetic patients (Paisey et al, 1980;Avignon et al, 1997;Bouma et al, 1999). Paisey et al (1980) have shown that a mean of at least three fasting capillary blood glucose have good correlation with HbA 1c (n ¼106). Avignon et al (1997) compared plasma glucose collected at different times during the day (prebreakfast, prelunch, postlunch, extended postlunch) with a single measurement of HbA 1c (n ¼66) taken within 10 days of the glucose data collection.…”

U.K. Prospective Diabetes Study: II. Reduction in HbA1c with Basal Insulin Supplement, Sulfonylurea, or Biguanide Therapy in Maturity-onset Diabetes

“…The fasting plasma glucose is a stable, repeatable measure of control in diet-treated patients 13 and sulfonylurea therapy can be used to reduce the fasting plasma glucose to <6 mmol/L 45 with an accompanying reduction in HbA 1c . Thus, the simple therapeutic aim of trying to reduce the fasting plasma glucose to <6 mmol/L is an effective means of reducing the HbA 1c to a high-normal level.…”