Fumi Honda: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Akira Hiramatsu: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Hideyuki Hyogo: Department of Gastroenterology and Hepatology, JA Hiroshima General Hospital, Hiroshima, Japan.
Hiroshi Aikata: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Kana Daijo: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Yuji Teraoka: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Yuki Inagaki: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Kei Morio: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Tomoki Kobayashi: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Takashi Nakahara: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Yuko Nagaoki: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Tomokazu Kawaoka: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Masayasu Yoneda: Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Masataka Tsuge: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Michio Imamura: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Yoshiiku Kawakami: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Hidenori Ochi: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Kazuaki Chayama: Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
BACKGROUND AND AIMS: The feature of blood glucose dynamics in patients with chronic liver disease (CLD) is marked blood glucose fluctuations. However, the detail of blood glucose dynamics is not well known. The aim of the present study was to evaluate glycemic fluctuations by continuous glucose monitoring (CGM). MATERIALS AND METHODS: A total of 105 CLD patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. Various parameters of glycemic variability were evaluated. The association of these parameters with liver functional reserve was examined. The parameters were also evaluated according to glycated hemoglobin A1c (HbA1c) levels. RESULTS AND DISCUSSION: Data of all patients showed that mean blood glucose (MBG) levels and the difference between highest and lowest blood glucose (ΔBG) increased significantly with worsening of liver functional reserve (P < 0.001 and P = 0.005, respectively). Although many of the cases were being treated for diabetes, postprandial hyperglycemia was seen in 92% of patients. Nocturnal hypoglycemia was seen in 22% of patients. In non-anemic patients with HbA1c levels of < 7.0%, the percentage of patients with mean amplitude of glycemic excursion (MAGE) of ≥ 77.4 mg/dL and that of MBG levels of > 145 mg/dL were higher in liver cirrhosis (LC) patients than in chronic hepatitis (CH) patients. In them, homeostasis model assessment for insulin resistance (HOMA-IR) of > 2.5 and LC were significantly associated with the increase in MAGE. LC was also significantly associated with increased MBG levels. CONCLUSION: The CGM systems were useful in finding hidden abnormalities of blood glucose fluctuations in CLD patients with T2DM, especially in non-anemic CLD patients with HbA1c levels of < 7.0%.
