Prevalence and extent of glycemic excursions in well-controlled patients with type 2 diabetes mellitus using continuous glucose-monitoring system.
BACKGROUND
Continuous glucose-monitoring system (CGMS) is a tool for assessment of glycemic excursions. Glucose variability is a risk factor independent of glycosylated hemoglobin (HbA1c) for diabetic complications; hence CGMS may be a better method for management of diabetes.


OBJECTIVE
To evaluate the extent of glycemic excursions in well-controlled type 2 diabetic patients.


METHODS
The study was carried out in 21 diabetic patients on oral agents.


METHODS
Patients underwent continuous glucose-monitoring by CGMS for 3 days. Number and duration of glycemic excursions, correlation coefficient (%) between CGMS and self-monitoring blood glucose (SMBG), mean absolute difference (%MAD) and complications of CGMS were analyzed.


METHODS
The statistical analyses were performed with the use of mean +/- SD, t-test and Mann-Whitney test.


RESULTS
The mean age of patients was 51.9 +/- 9.7 years. The mean HbA1c was 6.7 +/- 0.38%. The mean number of glycemic readings was 753.6 +/- 203.5 times. The correlation coefficient was 0.83 and the MAD was 11.7 +/- 8.0%, which were considerable. Three (14.2%) patients experienced, altogether, 9 hypoglycemic events with an average duration of 162 minutes. Twenty (94.7%) patients had hyperglycemic events. The mean duration of hyperglycemia was 19.4 +/- 12.8 hours. All events were asymptomatic. Disconnection of device was the most common complication (3 patients).


CONCLUSIONS
This study demonstrated that well-controlled type 2 diabetic patients have a considerable number of hypoglycemia and hyperglycemia events that may be missed by SMBG.
Mashhad University of Medical Science, Ghaem Hospital, Mashhad, Iran. bonakdaransh@mums.ac.ir
Shokoufeh
S
Bonakdaran
Reza
R
Rajabian
D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology* / Q000517:prevention & control*; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D008991:Monitoring, Physiologic; D015995:Prevalence; D012307:Risk Factors; D013223:Statistics as Topic
D006442:Glycated Hemoglobin