title: [Prediction of nocturnal hypoglycaemia with bedtime glucose level during continuous subcutaneous insulin infusion in type 2 diabetics].
abstract: OBJECTIVE
  To find out the features of glycemic excursion via continuous glucose monitoring system (CGMS) during continuous subcutaneous insulin infusion (CSII) treatment in type 2 diabetics and discuss the possibility of predicting nocturnal hypoglycaemia with bedtime glucose level.
  
  
  METHODS
  A total of 257 diabetes patients (156 males and 101 females, aged from 27 - 88 years old) with 0.1 - 40 years diabetic history were recruited. Their HbA1c level was (10.97 ± 2.11)%. Glycated albumin level was (31.88 ± 7.51)%. All patients were switched to CSII therapy while a 72-hour period of CGMS was performed. Participants were divided into hypoglycemia group and non-hypoglycemia group according to the reading of hypoglycemic events from CGMS data.
  
  
  RESULTS
  (1) From CGMS profiles, the investigators found that MBG was (9.66 ± 2.00) mmol/L and SDBG (2.98 ± 1.03) mmol/L. (2) A total of 243 hypoglycemia events occurred in 118 participants at early stage of CSII treatment. (3) When bedtime blood glucose was below 5.9 mmol/L, the youden index was maximal on a receiver operating characteristic curve. The sensitive was 54.8% and specificity 77.8%. Positive predictive value was 44.3% and negative predictive value 84.2%. So the cut-off point of bedtime blood glucose to predict nocturnal hypoglycemia might be 5.9 mmol/L.
  
  
  CONCLUSIONS
  (1) Hypoglycemia as detected by CGMS occurs in almost 1/2 type 2 diabetics during CSII therapy. (2) There is a higher risk of nocturnal hypoglycemia if the bedtime blood glucose concentration falls below 5.9 mmol/L.
authors.affiliation: Shanghai Jiaotong University, Shanghai Institute of Diabetes, Shanghai Diabetic Clinical Center, Shanghai 200233, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.forename: Yu-qian
authors.initials: YQ
authors.lastname: Bao
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Wei-ping
authors.initials: WP
authors.lastname: Jia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D007328:Insulin