Abstract
BackgroundWe aimed to examine the relationship between the occurrence of hypo-/hyperglycemia and HbA1c values, as assessed by continuous glucose monitoring (CGM) in patients with type 1 diabetes.MethodsThe study subjects comprised 101 type 1 diabetic patients on basal-bolus insulin therapy, who were put on masked CGM immediately after admission. The subjects were divided into four groups equally by HbA1c values and the 24-h CGM data were compared among the groups.ResultsGroups A to D comprised 24 patients with HbA1c ≤7.2 %, 26 patients with 7.2 % <HbA1c ≤8.2 %, 27 patients with 8.2 % <HbA1c ≤9.2 %, and 24 patients with HbA1c >9.2 %, respectively. The higher the HbA1c values, the significantly higher the 24-h mean glucose levels [median (25–75 percentiles)], with the HbA1c in groups A to D being 133 (114–155), 158 (132–188), 182 (152–206), and 186 (143–215) mg/dL, respectively (P < 0.001). Conversely, the higher the HbA1c values, the significantly shorter the time in hypoglycemia (<70 mg/dL), with the time in groups A to D being 170 (58–341), 78 (0–210), 45 (0–105), and 20 (0–105) min, respectively (P = 0.014); and the higher the HbA1c values, the significantly shorter the time in nocturnal hypoglycemia, with the time in groups A to D being 120 (5–269), 25 (0–120), 0 (0–60), and 0 (0–89) min, respectively (P = 0.019). No significant difference was seen between groups A to D in the standard deviations (SDs) of 24-h glucose values at 53 (40–65), 54 (45–70), 64 (55–76), and 58 (48–80), respectively.ConclusionIn type 1 diabetic patients, lower HbA1c was not associated with lower SD of 24-h glucose values, but may result in increased hypoglycemia.Trial Registration Current controlled trials UMIN000019190
Highlights
We aimed to examine the relationship between the occurrence of hypo-/hyperglycemia and HbA1c values, as assessed by continuous glucose monitoring (CGM) in patients with type 1 diabetes
We conducted a CGM-based study to compare durations of hypoglycemia and hyperglycemia in 40 type 2 diabetic patients receiving sulfonylureas, glinides, or insulin, which demonstrated that those with high HbA1c values were associated with longer durations of hyperglycemia than those with low HbA1c, while there were no significant differences in the proportion of patients with hypoglycemia and in the duration of hypoglycemia between those with high HbA1c values and those with low HbA1c values [5]
The study included a total of 101 patients with type 1 diabetes being treated with basal-bolus insulin therapy [insulin glargine or insulin detemir used as basal insulin, and insulin aspart or insulin lispro as bolus insulin; continuous subcutaneous insulin infusion (CSII) excluded] at our hospital, each of whom was subjected to CGM using CGMS GOLD
Summary
We aimed to examine the relationship between the occurrence of hypo-/hyperglycemia and HbA1c values, as assessed by continuous glucose monitoring (CGM) in patients with type 1 diabetes. The self-monitoring of blood glucose (SMBG) is widely used as a modality to help patients with diabetes keep track of their blood glucose levels on a daily. In this regard, real-time CGM, which is mainly used in routine clinical practice in the US and some European. Very few studies have explored whether varying HbA1c values may account for different durations of hypoglycemia in type 2 diabetic patients receiving hypoglycemic drugs that could cause hypoglycemia. We conducted a CGM-based study to compare durations of hypoglycemia and hyperglycemia in 40 type 2 diabetic patients receiving sulfonylureas, glinides, or insulin, which demonstrated that those with high HbA1c values were associated with longer durations of hyperglycemia than those with low HbA1c, while there were no significant differences in the proportion of patients with hypoglycemia and in the duration of hypoglycemia between those with high HbA1c values and those with low HbA1c values [5]
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