The importance of HbA1c and glucose variability in patients with type 1 and type 2 diabetes: outcome of continuous glucose monitoring (CGM)

Sartore, Giovanni; Chilelli, Nino Cristiano; Burlina, Silvia; Stefano, Paola Di; Piarulli, Francesco; Fedele, Domenico; Mosca, Andrea; Lapolla, Annunziata

doi:10.1007/s00592-012-0391-4

Cited by 65 publications

(65 citation statements)

References 33 publications

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“…It has been suggested that duration of diabetes, diabetic retinopathy [18], and treatment of diabetes (with or without insulin) [19] are related to HbA1c levels, and a relationship with self-efficacy has also been reported [20], [21]. However, in this study, there was no statistical relationship between HbA1c levels 12 weeks after discharge and the total self-efficacy score.…”

Section: Characteristiccontrasting

confidence: 60%

Decrease in Self-Efficacy for Exercise at 12 Weeks after Exercise Education in Diabetic Patients

Matsui¹,

Washida²,

Shoji³

et al. 2017

Health

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The purpose of this study was to investigate whether self-efficacy for exercise decreased 12 weeks after educational intervention in diabetic patients and whether this had an effect on glycemic control. Thirty-eight diabetic patients underwent a 2-week educational program and were then followed for 12 weeks after discharge. The intervention program was delivered by several types of medical professionals. Lectures on exercise were given by a physical therapist, who tailored exercise instructions for individual patients. The assessment of self-efficacy for exercise was performed using a scale from a previous study, modified for Japanese people. The scale consisted of four sub-items: physical fatigue, mental stress, lack of time, and poor weather. Measurements were performed at the time of discharge and 12 weeks after discharge. Glycated hemoglobin (HbA1c) levels were assessed as an index of glycemic control, and diabetic status and social status factors were recorded. The physical fatigue and lack of time components of the self-efficacy for exercise scale were significantly decreased 12 weeks after discharge. Positive correlations were found between HbA1c levels at 12 weeks and duration of diabetes, number of educational admissions, and presence of diabetic retinopathy. The results suggest that the factors that are difficult to reproduce during hospital education (physical fatigue and lack of time) are the ones that decrease after discharge. To clarify the relationship between changes in self-efficacy for exercise and glycemic control, further studies with an extended follow-up period (24 weeks or 48 weeks) are needed.

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Section: Characteristiccontrasting

confidence: 60%

Decrease in Self-Efficacy for Exercise at 12 Weeks after Exercise Education in Diabetic Patients

Matsui¹,

Washida²,

Shoji³

et al. 2017

Health

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“…Sartore et al (9) systematically investigated the relationship between the HbA1c levels and glucose variability indicators using CGM, and found that the HbA1c was not significantly correlated with glucose variability in patients with type 1 and type 2 diabetes. Schmitz et al (10) demonstrated that the HbA1c could represent an integrated measurement of sustained hyperglycemia during the previous few months, but could not reflect acute glucose fluctuations and postprandial glycemic variability.…”

Section: Discussionmentioning

confidence: 99%

Influence of Glycemic Variability on the HbA1c Level in Elderly Male Patients with Type 2 Diabetes

Feng

et al. 2012

Intern. Med.

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Objective To investigate the influence of glycemic variability on the HbA1c level in elderly male patients with type 2 diabetes (T2DM). Methods The 24-h glucose profiles were obtained using a continuous glucose monitoring system in 291 elderly male type 2 diabetic patients. The relationship between the glycemic variability and HbA1c level was assessed in these patients. Results The mean amplitude of glycemic excursions (MAGE) in patients with HbA1c " 7.0% was significantly higher than in patients with HbA1c <7.0% (4.33±1.67 vs. 3.48±1.46 mmol/L, p<0.001). A simple (Pearson's) correlation analysis indicated that the MAGE was significantly correlated with the HbA1c (r= 0.229, p<0.001). Compared with the lowest quartile, the highest quartile of the MAGE was associated with a significantly increased risk of having a HbA1c " 7.0% after multiple adjustments (p for trend <0.001). Conclusion The glycemic variability had a significant influence on the HbA1c level in elderly male patients with T2DM. The present data suggests that patients with higher glycemic variability might have higher HbA1c levels.

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“…Patients were randomized 1:1:1 to one of two different LY2605541 insulinstarting and adjusting algorithms or to GL, but as no differences were noted between the two LY arms (13), the data were combined. Eligible patients were aged 18 to 65 years with a diagnosis of type 2 diabetes for at least 1 year, had a hemoglobin A 1c (A1C) #10.5%, had a BMI between 19 and 45 kg/m 2 , and had been using metformin and/or a sulfonylurea in combination with GL or NPH insulin administered once daily (maximum dose ,1.0 units/kg/day) for at least 3 months. At enrollment, patients eligible for the main protocol were recruited by investigators to enroll in a protocol substudy that used CGM to evaluate the impact of LY2605541 on glycemic variability and time spent in hypoglycemia compared with GL.…”

Section: Methodsmentioning

confidence: 99%

Lower Glucose Variability and Hypoglycemia Measured by Continuous Glucose Monitoring With Novel Long-Acting Insulin LY2605541 Versus Insulin Glargine

et al. 2014

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OBJECTIVETo use continuous glucose monitoring (CGM) to evaluate the impact of the novel, long-acting basal insulin analog LY2605541 on hypoglycemia and glycemic variability in patients with type 2 diabetes. RESEARCH DESIGN AND METHODSHypoglycemia and glucose variability were assessed with CGM of interstitial glucose (IG) in a subset of patients with type 2 diabetes from a phase II, randomized, open-label, parallel study of LY2605541 (n = 51) or insulin glargine (GL) (n = 25). CGM was conducted on 3 consecutive days (72-84 h) during the week before week 0, 6, and 12 study visits. RESULTSMeasured by CGM for 3 days prior to the 12-week visit, fewer LY2605541-treated patients experienced hypoglycemic events overall (50.0 vs. 78.3%, P = 0.036) and nocturnally (20.5 vs. 47.8%, P = 0.027) and spent less time with IG £70 mg/dL than GL-treated patients during the 24-h (25 6 6 vs. 83 6 16 min, P = 0.012) and nocturnal periods (11 6 5 vs. 38 6 13 min, P = 0.024). These observations were detected without associated differences in the average duration of individual hypoglycemic episodes (LY2605541 compared with GL 57.2 6 5.4 vs. 69.9 6 10.2 min per episode, P = NS). Additionally, LY2605541-treated patients had lower within-day glucose SD for both 24-h and nocturnal periods. CONCLUSIONSBy CGM, LY2605541 treatment compared with GL resulted in fewer patients with hypoglycemic events and less time in the hypoglycemic range and was not associated with protracted hypoglycemia.

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The importance of HbA1c and glucose variability in patients with type 1 and type 2 diabetes: outcome of continuous glucose monitoring (CGM)

Cited by 65 publications

References 33 publications

Decrease in Self-Efficacy for Exercise at 12 Weeks after Exercise Education in Diabetic Patients

Decrease in Self-Efficacy for Exercise at 12 Weeks after Exercise Education in Diabetic Patients

Influence of Glycemic Variability on the HbA1c Level in Elderly Male Patients with Type 2 Diabetes

Lower Glucose Variability and Hypoglycemia Measured by Continuous Glucose Monitoring With Novel Long-Acting Insulin LY2605541 Versus Insulin Glargine

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