Resolution on the results of the first working meeting of the scientific advisory board «Actual problems of glycemic variability as a new criterion of glycemic control and safety of diabetes therapy»

Antsiferov, M.B. Antsiferov; Борисович, Анциферов Михаил; Galstyan, Gagik R.; Радикович, Галстян Гагик; Zilov, Alexey; Вадимович, Зилов Алексей; Mayorov, Alexander Y.; Юрьевич, Майоров Александр; Маркова, Т. Н.; Markova, T.V.; Demidov, Nikolay A.; Александрович, Демидов Николай; Koteshkova, O.M. Koteshkova; Михайловна, Котешкова Ольга; Лаптев, Д. Н.; Никитич, Лаптев Дмитрий; Vitebskaya, A. V.; Витальевна, Витебская Алиса

doi:10.14341/dm10227

Cited by 6 publications

(2 citation statements)

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“…В последние годы в качестве критериев компенсации СД1, кроме средних значений гликемии, все активнее обсуждаются показатели, отражающие амплитуду колебаний уровня глюкозы в крови в течение дня. «Золотым стандартом» для оценки вариабельности гликемии по данным самоконтроля, осуществляемого пациентами, признан коэффициент вариации [5]. В отчете глюкометра он обозначен как «изменчивость (среднее/ст.…”

Section: Discussionunclassified

Usage of glucometer with mobile application in real clinical practice

Витебская

2020

Medicinskij sovet

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Introduction. Glycemic control in patients with diabetes mellitus type 1 (DM1) can be held using glucometer with mobile application, continuous glucose monitoring (CGM), and intermediately scanned CGM (isCGM). isCGM do not need calibration with glucometer as CGM, but its usage in children and adolescents is recommended only together with glucometer.Aim: to study characteristics of glucometer usage in real clinical practice in a patient which utilizes glucometer with mobile application and is CGM simultaneously.Materials and methods. A 17-year-old girl with diabetes mellitus type 1 was advised to use isCGM together with glucometer Contour Plus One (ISO 15197:2013) and mobile application Contour Diabetes.Results. The first three months, while insulin dose titration and education, the patient used glucometer 1–9 times a day (3.0 (2.0; 4.0)), filled in diary. These led to decrease of glycaemia (10.7 (5.5; 14.7) – 7.8 (5.2; 9.5) mmol/L) and variability (56–45%), increase of percent of measurements within range (38–57%), according to glucometer; decrease of mean glycaemia (11.8–8.5 mmol/L) and increase of time in range (TIR) (14–59%), according to isCGM. The next three months, while diabetes mellitus type 1 compensation, according to glucometer (glycaemia 6.9 (4.9; 9.7) mmol/L, variability 48%, percent of measurements within range 71%) and isCGM (mean glycaemia mean glycaemia 7.3 mmol/L, TIR 67%), the patient stopped to fill in diary, decreased number of measurements by glucometer to 1.0 (1.0; 2.0) times a day. Mean month glycaemia was 5.5–9.8% lower according to glucometer than isCGM. The patient used glucometer in cases with relatively high risk of hypoglycemia more often.Conclusion. Usage of glucometer with mobile application can increase adherence to treatment. If glucometer and isCGM used simultaneously the patients measure glycaemia with glucometer in cases of decompensated diabetes mellitus type 1 and while insulin titration more often. Mean month glycaemia according to glucometer, if used every day, corresponds with isCGM data. We must discuss with patients circumstances when they use glucometer because this can influence glycemic control indicators in mobile application reports.

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Section: Discussionunclassified

Usage of glucometer with mobile application in real clinical practice

Витебская

2020

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“…According to the federal register of diabetes in the Russian Federation at the beginning of 2020, 4.76 million patients with diabetes were identified: type 1 diabetes - 5.6% (261.3 thousand), type 2 diabetes (T2DM) - 92.4% (4.40 million), other types of DM - 2% (97.1 thousand). However, only identified and registered cases of the disease are taken into account and according to the results of a large-scale Russian epidemiological study (NATION), it is known that only 54% of cases of type 2 diabetes are diagnosed [ 2 ]. Thus, DM can be detected much later, when complications such as retinopathy, nephropathy, and damage to the great vessels of the heart, brain, and arteries of the lower extremities occur due to chronic hyperglycemia, which is the main cause of disability and mortality in patients with diabetes [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The intensity of free radical processes and chaperone activity in the saliva of patients with type 2 diabetes

Cheprasova¹,

Попов²,

Пашков³

et al. 2023

BioMedicine

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Introduction Saliva is a clinically informative biological fluid that contains many biomarkers, allowing multiple analyses to be performed. Aim The objectives of this study were the assessment of the serum and saliva levels of biochemical parameters and intensity of free radical processes in T2DM patients and the identification of the correlation between certain criteria. Methods This case-control study included 40 T2DM patients, which were compared with 40 healthy individuals. The levels of glucose, cholesterol triglycerides, total protein, diene conjugates, and chaperone activity were measured using the spectrophotometric method. The concentration of 8-oxo-2′-deoxyguanosine was assessed by competitive enzyme-linked immunosorbent assay. Results It was established that the progression of diabetes led to an increase in glucose in saliva. The content of 8-oxo-2′-deoxyguanosine and conjugated dienes increased in serum and this increase was associated with the level of glucose and glycated hemoglobin. The level of protein and chaperone activity increased in the saliva of patients with T2DM compared with the control. The correlation analysis revealed a relationship between total protein concentration and conjugated dienes and between chaperone activity and conjugated dienes in saliva. Conclusions According to the results of the analysis, the pathological changes in DM affected the salivary glands and their secretions. The obtained results allowed us to recommend using saliva as an alternative to blood for the diagnosis and monitoring of T2DM treatments since it is readily available and quickly responds to changes in metabolism in the body.

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Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon

et al. 2021

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Backgraund: Children with type 1 diabetes mellitus (T1DM) need more insulin late in the evening (reverse dawn phenomenon (RDP)), and adolescents need more insulin yearly in the morning (dawn phenomenon (DP)); these cause blood glucose variability. Modern long acting insulin analogues allow to achieve satisfactory glycemic control.Aims: To study the characteristics of insulin therapy in children and adolescents with T1DM using insulin analogues detemir and degludec to overcome blood glucose variability caused by DP and RDP in different age periods.Materials and methods: We analyzed medical documents of 200 patients using detemir, admitted to pediatric endocrinology department in 2013–2019, at mean age 9.0 years (5.4; 13.0), with T1DM for 1.3 years (0.5; 3.0); and medical documents of 50 patients switched to degludec in 2018–2019 at mean age 12.0 years (10.5; 14.5) with T1DM for 3.0 years (1.5; 6.0). Before degludec they were on intensive insulin therapy with glargine (22), detemir (26), or insulin pump (2); 16 patients (32%) presented with clinical characteristics of DP, and 5 (10%) — RDP.Results: 67 children of 108 (62%) aged 1–9 years had redistribution of detemir doses to daytime; 58 adolescents of 92 (63%) aged 10–17 лет — to nighttime. Patients switched to degludec demonstrated decrease in HbA1с from 8.7% (7.8; 9.9) to 8.0% (7.4; 9.0) (р<0.001); fasting blood glucose from 9.8 mmol/l (7.4; 11.7) to 7.7 mmol/l (6.4; 8.6) (р<0.001); within-day variability from 35.2% (31.6; 40.9) to 23.5% (19.7; 28.6) (р<0.001); daily insulin dose from 0.98 U/kg/day (0.82; 1.14) to 0.87 U/kg/day (0.75; 1.07) (р=0.002). Sub-groups of patients with DP and RDP demonstrated decrease in fasting blood glucose (from 11.5 mmol/l (9.8; 13.8) to 7.5 mmol/l (6.6; 9.1) (р<0.001)), and late evening blood glucose (from 11.0 mmol/l (10.2; 11.2) to 8.0 mmol/l (6.7; 9.5) (р= 0.03)) correspondently. Achieved levels of glycemic control did not differ between sub-groups of patients initially using glargine or detemir.Conclusions: Compensation of T1DM may be complicated due to DP and RDP. Switching to degludec allowed to achieve better glycemic control and lowering of blood glucose variability caused by DP and DRP.

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Resolution on the results of the first working meeting of the scientific advisory board «Actual problems of glycemic variability as a new criterion of glycemic control and safety of diabetes therapy»

Cited by 6 publications

References 32 publications

Usage of glucometer with mobile application in real clinical practice

Usage of glucometer with mobile application in real clinical practice

The intensity of free radical processes and chaperone activity in the saliva of patients with type 2 diabetes

Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon

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