SELF BLOOD GLUCOSE MONITORING UNDERESTIMATES HYPERGLYCEMIA AND HYPOGLYCEMIA AS COMPARED TO CONTINUOUS GLUCOSE MONITORING IN TYPE 1 AND TYPE 2 DIABETES
When glucose records from self blood glucose monitoring (SBGM) do not reflect estimated average glucose from glycosylated hemoglobin (HgBA1) or when patients' clinical symptoms are not explained by their SBGM records, clinical management of diabetes becomes a challenge. Our objective was to det...
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| Veröffentlicht in: | Endocrine practice 2018-01, Vol.24 (1), p.47-52 |
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| creator | Mangrola, Devna Cox, Christine Furman, Arianne S Krishnan, Sridevi Karakas, Sidika E |
| description | When glucose records from self blood glucose monitoring (SBGM) do not reflect estimated average glucose from glycosylated hemoglobin (HgBA1) or when patients' clinical symptoms are not explained by their SBGM records, clinical management of diabetes becomes a challenge. Our objective was to determine the magnitude of differences in glucose values reported by SBGM versus those documented by continuous glucose monitoring (CGM).
The CGM was conducted by a clinical diabetes educator (CDE)/registered nurse by the clinic protocol, using the Medtronic iPRO2
system. Patients continued SBGM and managed their diabetes without any change. Data from 4 full days were obtained, and relevant clinical information was recorded. De-identified data sets were provided to the investigators.
Data from 61 patients, 27 with type 1 diabetes (T1DM) and 34 with T2DM were analyzed. The lowest, highest, and average glucose recorded by SBGM were compared to the corresponding values from CGM. The lowest glucose values reported by SBGM were approximately 25 mg/dL higher in both T1DM ( P = .0232) and T2DM ( P = .0003). The highest glucose values by SBGM were approximately 30 mg/dL lower in T1DM ( P = .0005) and 55 mg/dL lower in T2DM ( P |
| doi_str_mv | 10.4158/EP-2017-0032 |
| format | Article |
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The CGM was conducted by a clinical diabetes educator (CDE)/registered nurse by the clinic protocol, using the Medtronic iPRO2
system. Patients continued SBGM and managed their diabetes without any change. Data from 4 full days were obtained, and relevant clinical information was recorded. De-identified data sets were provided to the investigators.
Data from 61 patients, 27 with type 1 diabetes (T1DM) and 34 with T2DM were analyzed. The lowest, highest, and average glucose recorded by SBGM were compared to the corresponding values from CGM. The lowest glucose values reported by SBGM were approximately 25 mg/dL higher in both T1DM ( P = .0232) and T2DM ( P = .0003). The highest glucose values by SBGM were approximately 30 mg/dL lower in T1DM ( P = .0005) and 55 mg/dL lower in T2DM ( P<.0001). HgBA1c correlated with the highest and average glucose by SBGM and CGM. The lowest glucose values were seen most frequently during sleep and before breakfast; the highest were seen during the evening and postprandially.
SBGM accurately estimates the average glucose but underestimates glucose excursions. CGM uncovers glucose patterns that common SBGM patterns cannot.
CDE = certified diabetes educator; CGM = continuous glucose monitoring; HgBA1c = glycosylated hemoglobin; MAD = mean absolute difference; SBGM = self blood glucose monitoring; T1DM = type 1 diabetes; T2DM = type 2 diabetes.</description><identifier>ISSN: 1530-891X</identifier><identifier>EISSN: 1934-2403</identifier><identifier>DOI: 10.4158/EP-2017-0032</identifier><identifier>PMID: 29144814</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Adult ; Aged ; Atherosclerosis ; Blood Glucose - metabolism ; Blood Glucose Self-Monitoring - methods ; Cardiovascular disease ; Diabetes ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetes Mellitus, Type 1 - metabolism ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - metabolism ; Diabetic retinopathy ; Fasting ; Female ; Glucose ; Glucose monitoring ; Glycated Hemoglobin A - metabolism ; Humans ; Hyperglycemia ; Hyperglycemia - diagnosis ; Hyperglycemia - metabolism ; Hypoglycemia ; Hypoglycemia - chemically induced ; Hypoglycemia - diagnosis ; Hypoglycemia - metabolism ; Hypoglycemic Agents - therapeutic use ; Insulin ; Insulin - therapeutic use ; Male ; Meals ; Middle Aged ; Monitoring, Ambulatory - methods ; Postprandial Period ; Sensors</subject><ispartof>Endocrine practice, 2018-01, Vol.24 (1), p.47-52</ispartof><rights>Copyright Allen Press Publishing Services Jan 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c319t-f06705f83d268a7c69762a61510be299671e5d3c9b3b8bb2be059a07e0f8f7fb3</citedby><cites>FETCH-LOGICAL-c319t-f06705f83d268a7c69762a61510be299671e5d3c9b3b8bb2be059a07e0f8f7fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1992605702?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29144814$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mangrola, Devna</creatorcontrib><creatorcontrib>Cox, Christine</creatorcontrib><creatorcontrib>Furman, Arianne S</creatorcontrib><creatorcontrib>Krishnan, Sridevi</creatorcontrib><creatorcontrib>Karakas, Sidika E</creatorcontrib><title>SELF BLOOD GLUCOSE MONITORING UNDERESTIMATES HYPERGLYCEMIA AND HYPOGLYCEMIA AS COMPARED TO CONTINUOUS GLUCOSE MONITORING IN TYPE 1 AND TYPE 2 DIABETES</title><title>Endocrine practice</title><addtitle>Endocr Pract</addtitle><description>When glucose records from self blood glucose monitoring (SBGM) do not reflect estimated average glucose from glycosylated hemoglobin (HgBA1) or when patients' clinical symptoms are not explained by their SBGM records, clinical management of diabetes becomes a challenge. Our objective was to determine the magnitude of differences in glucose values reported by SBGM versus those documented by continuous glucose monitoring (CGM).
The CGM was conducted by a clinical diabetes educator (CDE)/registered nurse by the clinic protocol, using the Medtronic iPRO2
system. Patients continued SBGM and managed their diabetes without any change. Data from 4 full days were obtained, and relevant clinical information was recorded. De-identified data sets were provided to the investigators.
Data from 61 patients, 27 with type 1 diabetes (T1DM) and 34 with T2DM were analyzed. The lowest, highest, and average glucose recorded by SBGM were compared to the corresponding values from CGM. The lowest glucose values reported by SBGM were approximately 25 mg/dL higher in both T1DM ( P = .0232) and T2DM ( P = .0003). The highest glucose values by SBGM were approximately 30 mg/dL lower in T1DM ( P = .0005) and 55 mg/dL lower in T2DM ( P<.0001). HgBA1c correlated with the highest and average glucose by SBGM and CGM. The lowest glucose values were seen most frequently during sleep and before breakfast; the highest were seen during the evening and postprandially.
SBGM accurately estimates the average glucose but underestimates glucose excursions. CGM uncovers glucose patterns that common SBGM patterns cannot.
CDE = certified diabetes educator; CGM = continuous glucose monitoring; HgBA1c = glycosylated hemoglobin; MAD = mean absolute difference; SBGM = self blood glucose monitoring; T1DM = type 1 diabetes; T2DM = type 2 diabetes.</description><subject>Adult</subject><subject>Aged</subject><subject>Atherosclerosis</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Glucose Self-Monitoring - methods</subject><subject>Cardiovascular disease</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes Mellitus, Type 1 - metabolism</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - metabolism</subject><subject>Diabetic retinopathy</subject><subject>Fasting</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose monitoring</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hyperglycemia - diagnosis</subject><subject>Hyperglycemia - metabolism</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - chemically induced</subject><subject>Hypoglycemia - diagnosis</subject><subject>Hypoglycemia - metabolism</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin</subject><subject>Insulin - therapeutic use</subject><subject>Male</subject><subject>Meals</subject><subject>Middle Aged</subject><subject>Monitoring, Ambulatory - methods</subject><subject>Postprandial Period</subject><subject>Sensors</subject><issn>1530-891X</issn><issn>1934-2403</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNptkUtPg0AUhSdGY2t159pM4lb0zgyPmSXClJIAQ3gkdkWghcTG2grtwj_i7xXaqhtX9-Tk5DvJPQjdEnjUicGfZKxRIJYGwOgZGhPBdI3qwM57bTDQuCAvI3TVdSsACoLwSzSigug6J_oYfaUymOLnQCkXe0HuqFTiUEV-phI_8nAeuTKRaeaHdiZTPJvHMvGCuSND38Z25A6O-jNS7KgwthPp4kz1Osr8KFd5-h_aj3DW4zA5cA6SYte3n2XfdI0umvKtq29Od4LyqcycmRYoz3fsQFswInZaA6YFRsPZkpq8tBamsExamsQgUNVUCNMitbFkC1GxilcVrWowRAlWDQ1vrKZiE3R_5G7bzce-7nbFarNv3_vKgghBTTAsoH3q4ZhatJuua-um2Lav67L9LAgUwwiFjIthhGIYoY_fnaD7al0vf8M_X2ff7Dt06g</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Mangrola, Devna</creator><creator>Cox, Christine</creator><creator>Furman, Arianne S</creator><creator>Krishnan, Sridevi</creator><creator>Karakas, Sidika E</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>201801</creationdate><title>SELF BLOOD GLUCOSE MONITORING UNDERESTIMATES HYPERGLYCEMIA AND HYPOGLYCEMIA AS COMPARED TO CONTINUOUS GLUCOSE MONITORING IN TYPE 1 AND TYPE 2 DIABETES</title><author>Mangrola, Devna ; 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Our objective was to determine the magnitude of differences in glucose values reported by SBGM versus those documented by continuous glucose monitoring (CGM).
The CGM was conducted by a clinical diabetes educator (CDE)/registered nurse by the clinic protocol, using the Medtronic iPRO2
system. Patients continued SBGM and managed their diabetes without any change. Data from 4 full days were obtained, and relevant clinical information was recorded. De-identified data sets were provided to the investigators.
Data from 61 patients, 27 with type 1 diabetes (T1DM) and 34 with T2DM were analyzed. The lowest, highest, and average glucose recorded by SBGM were compared to the corresponding values from CGM. The lowest glucose values reported by SBGM were approximately 25 mg/dL higher in both T1DM ( P = .0232) and T2DM ( P = .0003). The highest glucose values by SBGM were approximately 30 mg/dL lower in T1DM ( P = .0005) and 55 mg/dL lower in T2DM ( P<.0001). HgBA1c correlated with the highest and average glucose by SBGM and CGM. The lowest glucose values were seen most frequently during sleep and before breakfast; the highest were seen during the evening and postprandially.
SBGM accurately estimates the average glucose but underestimates glucose excursions. CGM uncovers glucose patterns that common SBGM patterns cannot.
CDE = certified diabetes educator; CGM = continuous glucose monitoring; HgBA1c = glycosylated hemoglobin; MAD = mean absolute difference; SBGM = self blood glucose monitoring; T1DM = type 1 diabetes; T2DM = type 2 diabetes.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>29144814</pmid><doi>10.4158/EP-2017-0032</doi><tpages>6</tpages></addata></record> |
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| ispartof | Endocrine practice, 2018-01, Vol.24 (1), p.47-52 |
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| language | eng |
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| subjects | Adult Aged Atherosclerosis Blood Glucose - metabolism Blood Glucose Self-Monitoring - methods Cardiovascular disease Diabetes Diabetes Mellitus, Type 1 - drug therapy Diabetes Mellitus, Type 1 - metabolism Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - metabolism Diabetic retinopathy Fasting Female Glucose Glucose monitoring Glycated Hemoglobin A - metabolism Humans Hyperglycemia Hyperglycemia - diagnosis Hyperglycemia - metabolism Hypoglycemia Hypoglycemia - chemically induced Hypoglycemia - diagnosis Hypoglycemia - metabolism Hypoglycemic Agents - therapeutic use Insulin Insulin - therapeutic use Male Meals Middle Aged Monitoring, Ambulatory - methods Postprandial Period Sensors |
| title | SELF BLOOD GLUCOSE MONITORING UNDERESTIMATES HYPERGLYCEMIA AND HYPOGLYCEMIA AS COMPARED TO CONTINUOUS GLUCOSE MONITORING IN TYPE 1 AND TYPE 2 DIABETES |
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