Continuous glucose monitoring to assess glucose variability in type 3c diabetes.

Victoria T Y Lee, Ann Poynten, Barbara Depczynski
Author Information
  1. Victoria T Y Lee: Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
  2. Ann Poynten: Department of Endocrinology, Diabetes and Metabolism, Prince of Wales Hospital, Sydney, New South Wales, Australia.
  3. Barbara Depczynski: Department of Endocrinology, Diabetes and Metabolism, Prince of Wales Hospital, Sydney, New South Wales, Australia.

Abstract

AIM: The effectiveness of continuous glucose monitoring (CGM) in maintaining glycaemic control in type 1 diabetes mellitus and type 2 diabetes mellitus has been well demonstrated. However, the degree of glycaemic variability (GV) in people with type 3c diabetes mellitus has not been fully explored using CGM. This study aims to evaluate GV in type 3c diabetes mellitus participants and compare it to type 1 diabetes mellitus and type 2 diabetes mellitus.
METHODS: Participants were grouped according to type of diabetes. GV, defined as percentage coefficient of variation (%CV), and other glycaemic indices were obtained using CGM (FreeStyle Libre, Abbott, Australia) from 82 participants across all three cohorts over a 14-day period. Comparison of baseline characteristics and GV were performed across all groups. Correlation of GV with C-peptide values, and whether pancreatic supplementation had an effect on GV were also assessed in the type 3c diabetes mellitus cohort.
RESULTS: GV of type 3c diabetes mellitus participants was within the recommended target of less than %CV 36% (p = 0.004). Type 3c diabetes mellitus participants had the lowest GV among the three groups (p = 0.001). There was a trend for lower C-peptide levels to be associated with higher GV in type 3c diabetes mellitus participants (p = 0.22). Pancreatic enzyme supplementation in type 3c diabetes mellitus participants did not have an effect on GV (p = 0.664).
CONCLUSIONS: Although type 3c diabetes mellitus participants were the least variable, they had the highest mean glucose levels and estimated HbA , which suggests that the concept of 'brittle' diabetes in type 3c diabetes mellitus is not supported by the results of CGM in this study and may be leading to poorer glycaemic control.

Keywords

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MeSH Term

Blood Glucose
Blood Glucose Self-Monitoring
C-Peptide
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Glucose
Glycated Hemoglobin
Humans
Hyperglycemia

Chemicals

Blood Glucose
C-Peptide
Glycated Hemoglobin A
Glucose

Word Cloud

Created with Highcharts 10.0.0diabetestypemellitusGV3cparticipantsglucoseglycaemicCGMmonitoringvariabilityC-peptidep = 0continuouscontrol12usingstudy%CVacrossthreegroupssupplementationeffectlevelsAIM:effectivenessmaintainingwelldemonstratedHoweverdegreepeoplefullyexploredaimsevaluatecompareMETHODS:ParticipantsgroupedaccordingdefinedpercentagecoefficientvariationindicesobtainedFreeStyleLibreAbbottAustralia82cohorts14-dayperiodComparisonbaselinecharacteristicsperformedCorrelationvalueswhetherpancreaticalsoassessedcohortRESULTS:withinrecommendedtargetless36%004Typelowestamong001trendlowerassociatedhigherp = 022Pancreaticenzyme664CONCLUSIONS:AlthoughleastvariablehighestmeanestimatedHbAsuggestsconcept'brittle'supportedresultsmayleadingpoorerContinuousassess

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