glycemic variability and hypoglycemia

Beyond HbA1c: Comparing Glycemic Variability and Glycemic Indices in Predicting Hypoglycemia in Type 1 and Type 2 Diabetes. Waeschle RM, Moerer O, Hilgers R, Herrmann P, Neumann P, Quintel M: The impact of the severity of sepsis on the risk of hypoglycemia and glycemic variability. GV is also a marker of the instability of a person’s metabolic system, expressed as frequent high and low glucose excursions and overall volatile glycemic control. ABSTRACT Objective Observations in real-world settings support and extend findings demonstrated in randomized controlled trials that show … In young adults with type 1 diabetes, self-reported fear of hypoglycemia was associated with greater glycemic variability, increased calorie intake and reduced physical activity, study findings show. However, the SGO group had a higher incidence of hypoglycemia (median, 3.5%) than DO group (both fasting and non-fasting periods, p < 0.05 for both), HC (fasting, p < 0.05), and the SGD group (fasting, p < 0.05). However, glucose variability remained relatively unchanged from … Glycemic variability was calculated as the standard deviation of the blood glucose concentrations. The … Hyperglycemia, hypoglycemia, and glycemic variability (GV) have been linked to adverse clinical outcomes, which will be briefly discussed below. HbA1c variability is independent of mean HbA1c, and associated with mortality due to vascular complications. Secondary analyses from the DEVOTE trial comparing the ultralong-acting insulin degludec with insulin glargine examine associations between glycemic variability and severe hypoglycemia and outcomes. OBJECTIVE Roux-en-Y gastric bypass (RYGB) is an established treatment for type 2 diabetes and obesity. Although higher individualized HbA1c targets are perceived to reduce the risk of hypoglycemia in those at risk of hypoglycemia, HbA1c itself is a poor predictor of hypoglycemia. It is important to use the least insulin dose, with the target of minimizing glycemic variability, to achieve good glycemic control without hypoglycemia. Hypoglycemia is a common condition in the neonatal population ().It has a significant prevalence in at risk infants, with that of 47% in large-for-gestational age (LGA) infants, 52% in small-for-gestational age (SGA) infants, 48% in neonates of diabetic mothers, and 54% in late preterm infants ().In infants born before 33 weeks, the prevalence of hypoglycemia is nearly … The determination of clinical variables, such as GFR <45 mL/min, HbA1C >9% and hypoglycemia history, was associated with a high GV. A downward trend in blood levels of glucose is evident; levels of HbA 1c (estimated by the use of a linear formula) decreased from 9.4% at baseline to 7.5% by the end of the observation period. Materials and Methods. Fluctuations in blood glucose concentrations might only represent high glycemic variability. Fear of hypoglycemia (FOH) is a barrier to attaining optimal glucose control that may trigger behaviors that contribute to greater glycemic variability in T1DM. iate the effect of intensive glycemic control with renal transplant outcomes have not been identified. In this review, the author discusses topics related to the assessment, … Crit Care 2008, 12: R129. Glycemic variability (GV), defined as an integral component of glucose homoeostasis, is emerging as an important metric to consider when assessing glycemic control in clinical practice. The diaTribe Foundation is pleased to share the Glycemic Outcomes Beyond A1c Resources page, which includes coverage of the July gathering and the meetings leading up to "Glycemic Outcomes Beyond A1C", materials from the day (i.e. We assessed the use of glycemic variability (GV) and glycemic indices as independent predictors of hypoglycemia. PubMed Central Article PubMed Google Scholar 2. Thus, elderly patients with diabetes require treatments that can prevent diabetic complications by stabilizing glycemic variability (GV) without hypoglycemia . It is increasingly recognized that glycemic variability (GV), referring to oscillations in blood glucose levels and representing either short-term or long-term GV, is involved in the pathogenesis of diabetic complications and has emerged as a possible … We carried out continuous glucose monitoring in 281 outpatients with type 2 diabetes mellitus who participated in a multicenter cohort (Hyogo Diabetes Hypoglycemia Cognition Complications) study. Hypothesis: Insulin induces PHH in healthy cats, and PHH is associated with poorly regulated … We found that VSG increases glycemic variability, and specifically in response to a mixed-meal liquid gavage, hypoglycemia is readily detectable. Hypoglycemia was defined as BG ≤70 mg/dl (3.9 mmol/L) or BG <54 mg/dl (3.0 mmol/L). glycemic variability and hypoglycemia The hypothesis that the maintenance of close glycemic control is of importance in all of the clinical settings is highlighted by the recent evidence that in individuals with normal glucose tolerance, glycemia is maintained within a narrow range between 68.4 and 138.6 mg/dL [ 50 ]. For personal use only. Wang 2 na1, B. Ding 1, J. Zhu 1, T. Jing 1, L. Ye 3, K.-O. Lee 4, J.-d. Wu 1 & J.-h. Ma 1 Journal of Endocrinological Investigation volume 41, pages 539–547 (2018)Cite this article Methods A secondary data analysis of 93 participants (n=44 intensive, n=49 control) was conducted using data from a previous randomized controlled clinical trial. Although it remains yet no consensus, accumulating evidence has suggested that GV, representing either short-term (with-day and between-day variability) or long-term GV, was … Although there are not yet enough data to offer guidelines for glycemic variability, a good rule of thumb is an SD that is less than half of the average blood glucose level. Hyperglycemia. RESEARCH DESIGN AND METHODS. Aged; Aged, 80 and over; Blood Glucose/analysis* Blood Glucose Self-Monitoring* Cross-Sectional Studies ; Diabetes Mellitus, Type 2/blood* Diabetes Mellitus, Type 2/drug … This was a prospective observational study of 10 participants with obesity and prediabetes or type 2 diabetes who underwent RYGB. Glycemic variability. Treatment of hypoglycemia with dextrose 50% can overcorrect blood glucose levels and increase glucose variability. Hyperglycemia, hypoglycemia and increased glycemic variability are independently associated with increased risk of mortality in critically ill patients. Glycemic variability (GV) a well-established risk factor for hypoglycemia and a suspected risk factor for diabetes complications. agenda, presentations, patient video), notable journal articles written on glycemic variability, hypoglycemia, future clinical … When glycemic variability or hyperglycemia was … We conducted a retrospective pilot study … 10.1186/cc7097. Hypoglycemia was the parameter with the highest RR for mortality, followed by hyperglycemia and glycemic variability. Glycemic variability was calculated as the standard deviation of the blood glucose concentrations. A1C may also inform the accuracy of the patient's CGM or meter … Among diabetic cats with hypoglycemia, 33 (25%) had PHH. Although it has not yet been definitively confirmed as an independent risk factor for diabetes complications, glycaemic variability can represent the presence of excess glycaemic excursions and, consequently, the risk of hyperglycaemia or hypoglycaemia. All three glycemic indices (hyperglycemia, glycemic variability, and hypoglycemia) have been associated with ROS production. The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study ... (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. Association of Glycemic Indices (Hyperglycemia, Glucose Variability, and Hypoglycemia) with Oxidative Stress and Diabetic Complications. Glycemic variability was assessed by calculating mean Coefficient of Variation (CV). Fasting c-peptide and fasting glucose were measured … We carried out continuous glucose monitoring in 281 outpatients with type 2 diabetes mellitus who participated in a multicenter cohort (Hyogo Diabetes Hypoglycemia Cognition Complications) study. Background: Little information is available about posthypoglycemic hyperglycemia (PHH) in diabetic cats, and a causal link between hypoglycemia and subsequent hyperglycemia is not clear. is corrected by. L.-l. Jiang 1 na1, S.-q. Lastly, blockade of GLP-1R signaling prevents falls in the glucose nadir but does not improve glycemic variability. Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, … The study objective was to establish RYGB's effects on glycemic variability (GV) and hypoglycemia. RESEARCH DESIGN AND METHODS This was a prospective observational study of 10 participants with obesity and prediabetes or type 2 diabetes who underwent RYGB. Results. We investigated the relationships between TIR, glycemic variability and patient characteristics in patients with type 2 diabetes mellitus. Hypoglycemia and glucose variability are independently associated with increased mortality in septic, surgical, and mixed intensive care unit (ICU) patients. Glycemic variability is another factor that likely contributes to complications of diabetes, including negative effects on mood and cognition, as well as the risk of hypoglycemia. Gardner; Suresh Rama … Hypoglycemia and Glycemic Variability in Patients with Type 2 Diabetes Mellitus Application of the Continuous Glucose Monitoring System (CGMS) Subcutaneous tissue … Results: In healthy cats, all insulin doses caused hypoglycemia but PHH was not observed; glycemic variability did not differ between insulin preparations. Hypoglycemia also yielded the highest RR for the need for RRT. Hyperglycemia with high variability and occurrence of hypoglycemia showed a higher GDI value than the same condition without hypoglycemia, even though the MBG and eHbA1c values were at lower levels (A vs. B), indicating that hypoglycemia is an influential factor in increasing glycemic deviation in our formula. OBJECTIVE To evaluate the respective contributions of short-term glycemic variability and mean daily glucose (MDG) concentration to the risk of hypoglycemia in type 1 diabetes. Glycemic variability and hypoglycemia duration were assessed from continuous glucose monitoring data recorded over 6 consecutive days. It is well accepted that hyperglycemia in diabetes directly contributes to short/long-term microvascular complications and has a long-term role in the development of macrovascular disease. It is possible to have a normal HbA1c … RESEARCH DESIGN AND METHODS People with type 1 diabetes (n = 100) investigated at the University Hospital of Montpellier (France) underwent continuous glucose monitoring (CGM) on two … Results: … Gaps in knowledge exist related to the association of FOH and glycemic variability; CGM technology allows examination of these relationships. In addition, severe hypoglycemia was found to be associated with dementia , cardiovascular diseases and mortality risk in these patients. Correction to: Diabetes Technol Ther 2018;20(5) :353–362; Suresh Rama Chandran, Wei Lin Tay, Weng Kit Lye, Lee Ling Lim, Jeyakantha Ratnasingam, Alexander Tong Boon Tan, and ; Daphne S.L. glycemic variability and hypoglycemia: real-world data from Spain ... glycemic variability glucometrics obtained from CGM can be used as clinical and research variables of gly-cemic control and acute and chronic complication risk. We examined inflammatory biomarkers, glycemic variability, hypoglycemia, and hyperglycemia as potential … We investigated the relationships between TIR, glycemic variability and patient characteristics in patients with type 2 diabetes mellitus. glycemic variability and glycemic indices in predicting hypoglycemia 9 Downloaded by National University of Singapore NUS SWETS/24793917 from www.liebertpub.com at 04/24/18. by Manya Goldstein | Dec 10, 2020 | 0 comments. It has been demonstrated that increased glucose variability is a predictor of hypoglycemia, which is the main limiting factor for achieving the recommended HbA1c target. The effects of add-on exenatide to insulin on glycemic variability and hypoglycemia in patients with type 1 diabetes mellitus. These responses were seen very early after surgery and therefore offer an experimental model of PBH that could … A1C does not provide a measure of glycemic variability or hypoglycemia. The relationship between glucose variability and hypoglycemia … An excess of highs and lows in blood sugar is referred to as “glycemic variability” and can be harmful beyond the presence of highs and lows. Risk of hypoglycemia and improved glycemic control. Materials and Methods. These are benefits that might be further enhanced with integration of diet and exercise and perhaps translate to PX patients; … Introduction. Compared with cats without PHH, their daily insulin … However, the significance of HbA1c variability is unknown at present. Introduction: In the struggle for tight glycemic control many type 1 diabetes patients daily experience large blood glucose fluctuations. 5,7 Several mechanisms … Various mechanisms associated with hyperglycemia, such as the production of AGEs, the activation of PKC, the accumulation of sorbitol, and the hyperactivity of the hexosamine pathway, lead to reactive oxygen species overproduction and a decrease in the … In this study, we used flash glucose monitoring (FGM) and evaluated glycemic intraday variations, and then examined the association with HbA1c variability. CGM has been shown to improve glycemic control in patients with T1D, leading to a greater decline in HbA 1c compared with self-monitoring, reducing glycemic variability, risk of hypoglycemia and hyperglycemia, and improving quality of life . Results: In healthy cats, all insulin doses caused hypoglycemia but PHH was not observed; glycemic variability did not differ between insulin preparations. Patients were studied before RYGB (Pre) and 1 month, 1 year, and 2 years postsurgery with continuous glucose … Glycaemic variability is an integral component of glucose homoeostasis. Glycaemic variability is currently defined by a large and … Diabetes mellitus is the major risk factor for the development of macrovascular and microvascular complications. The “blood sugar roller coaster” effect itself can possibly damage the heart as well as exacerbate other serious health concerns. Glycemic Variability Glycemic variability refers to swings in blood glucose levels; it means the oscillations that occur throughout the day, including episodes of hypoglycemia and postprandial hyperglycemia.13 26 27 Clinical data on GV assess short-term—both intraday and day-to-day GV—as well as long-term GV based on fluctuations in blood glucose after weeks or months assessed by HbA1c, SMBG and … The study objective was to establish RYGB’s effects on glycemic variability (GV) and hypoglycemia. For patients prone to glycemic variability, especially patients with type 1 diabetes or type 2 diabetes with severe insulin deficiency, glycemic control is best evaluated by the combination of results from SMBG or CGM and A1C. PMID: 29293363 [Indexed for MEDLINE] MeSH terms. Our data suggest that the use of technology and treatments able to reduce glycemic variability could be useful in this population to reduce the risk of hypoglycemia and to improve glycemic control. Among diabetic cats with hypoglycemia, 33 (25%) had PHH. Notable differences were observed within and between groups (Supplementary Table 3). Results. The … Self-monitored blood levels of glucose recorded over 60 days.

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