Use of Continuous Glucose Monitoring Data for Defining Glucose Control in Insulin-Treated Patients

Abstract

Glycated haemoglobin (HbA1c) and self-monitoring of blood glucose (SMBG) are usually used to define glucose control in diabetic patients, but in many cases they are insufficient to present overall control. Continuous Glucose Monitoring (CGM) is used for adjustment of insulin doses but derived data could help to define glucose control. We assess the use of CGM data for defining control in subgroup of patients treated with insulin. We studied 75 diabetic patients (43 men, 32 women; age 55.23±8.99 years, disease duration 12.84±7.02 years) - 33 with type 2 diabetes on pre-mixed insulin, 21 with type 2 on multiple insulin injection (MII), 21 with type 1 on MMI. Patients did multiple daily blood glucose measurements of fasting and prandial blood glucose for three month period. HbA1c was measured and CGM by using iProTM for seven days was performed at the end of this period. Based on HbA1c assessment 36.36% of patients on premixed insulin, 19.05% of type 2 patients on MII and 9.52% of type 1 patients on MII were with good control. After estimation of results from SMBG these percentage were respectively 28.14%, 12.11%, 4.51%. CGM defined 27.27% of patients on premixed insulin, 23.80% of type 2 patients on MII and 2.38% of type 1 patients on MII as well controlled. In addition CGM gave information about insulin excursion - they were with no significant difference in the three groups (17.09±7.01, p=0.231). CGM was more informative than SMBG in presenting hypoglycemic episode (p=0.01) including night hypoglycemia and especially their duration (p=0.001). No difference was found in different groups with no dependence on type of diabetes or insulin regimen. Nevertheless of short observed period CGM data could give much information about overall glucose control that is comparable to three month blood glucose measurement and are better than other methods in estimating hypoglycemic episodes. Performing of CGM should be included in recommendations for assessment of glucose control. Disclosure T. Totomirova: None. I. Daskalova: None. M. Arnaudova: None.