Blood Glucose Monitoring In Patients Research Articles

Microenvironment-optimized GelMA microneedles for interstitial fluid extraction and real-time glucose detection

Microneedle (MN) patches have shown great potential for interstitial fluid (ISF) sampling and subsequent analytes detection, providing an alternative pathway for clinical diagnosis based on blood tests. However, MNs based detection is generally based on separate downstream assays, which cannot provide the detection in real-time. Specifically in the context of glucose monitoring, it is desirable to know the glucose level rapidly so as to guide the subsequent treatment in patients. Here, we designed a double layer MNs patch with the crosslinked gelatin methacryloyl (GelMA) tips loaded with glucose oxidase (GOx), whereas the substrate loaded with horseradish peroxidase (HRP), and 3,3′,5,5′-tetramethylbenzidine (TMB). The MNs tips allow for the ISF sampling and detect the glucose in situ via an enzymatic cascade reaction. We used 3D printing technology for MNs molding, which facilitate the customizable MNs design and optimization. Furthermore, we improved the detection sensitivity and accuracy by optimizing the microenvironment of the GelMA and the concentration of each enzymes. The performance of this MNs patch is validated in extracting and detecting glucose using an agarose gel based skin model. The results showed that within the glucose concentration range of 1.7–21 mmol/L, the MNs patch could accurately measure the unknown glucose concentration through the color values of red, green, and blue (RGB) obtained from scanned images. The all-in-one MNs patch with colorimetric functionality is easy to use and does not require specialized personnel or large-scale equipment support, making it highly promising for clinical translation and providing real -time blood glucose monitoring for patients.

Blood glucose trajectories and incidence of diabetes mellitus in Ugandan people living with HIV initiated on dolutegravir

BackgroundFollowing reports of anti-retroviral therapy (ART) experienced Ugandan people living with HIV (PLHIV) presenting with diabetic ketoacidosis weeks to months following a switch to dolutegravir (DTG), the Uganda Ministry of Health recommended withholding DTG in both ART naïve and experienced PLHIV with diabetes mellitus (T2DM), as well as 3-monthly blood glucose monitoring for patients with T2DM risk factors. We sought to determine if the risk of T2DM is indeed heightened in nondiabetic ART naïve Ugandan PLHIV over the first 48 weeks on DTG.MethodsBetween January and October 2021, 243 PLHIV without T2DM were initiated on DTG based ART for 48 weeks. Two-hour oral glucose tolerance tests (2-h OGTT) were performed at baseline, 12, and 36 weeks; fasting blood glucose (FBG) was measured at 24 and 48 weeks. The primary outcome was the incidence of T2DM. Secondary outcomes included: incidence of pre-Diabetes Mellitus (pre-DM), median change in FBG from baseline to week 48 and 2-h blood glucose (2hBG) from baseline to week 36. Linear regression models were used to determine adjusted differences in FBG and 2hBG from baseline to weeks 48 and 36 respectively.ResultsThe incidence of T2DM was 4 cases per 1000 PY (1/243) and pre-DM, 240 cases per 1000 person years (PY) (54/243). There was a significant increase in FBG from baseline to week 48 [median change from baseline (FBG): 3.6 mg/dl, interquartile range (IQR): − 3.6, 7.2, p-value (p) = 0.005] and significant reduction in 2hBG (2hBG: − 7.26 mg/dl, IQR: − 21.6, 14.4, p = 0.024) at week 36. A high CD4 count and increased waist circumference were associated with 2hBG increase at week 36.ConclusionWe demonstrated a low incidence of T2DM in Ugandan ART-naïve patients receiving DTG. We also demonstrated that longitudinal changes in BG were independent of conventional risk factors of T2DM in the first 48 weeks of therapy. Restricting the use of dolutegravir in Ugandan ART naïve patients perceived to be high risk for diabetes mellitus may be unwarranted.

Research status of ambulatory blood glucose monitoring in patients with type 2 diabetes mellitus

Research status of ambulatory blood glucose monitoring in patients with type 2 diabetes mellitus

Oxidative status, carbohydrate, and lipid metabolism indicators in saliva and blood serum of type 1 diabetes mellitus patients

Introduction: Diabetes mellitus (DM) is an acute biomedical problem whose prevalence in the Russian Federation and elsewhere continues to rise. Regular blood glucose monitoring in patients with DM requires the identification of new approaches for the non-invasive assessment of glycemic parameters. Previous studies assessing the relationship between the biochemical composition of saliva and blood plasma found saliva suitable for DM monitoring. In this study, we assessed correlations between oxidative status and carbohydrate and lipid metabolism indicators in saliva and blood serum of patients with type 1 DM (T1DM). Methods: We included 80 adults, 40 T1DM patients divided equally into two sex-defined subgroups, 20 men (mean age 43.7 +/- 3.21) and 20 women (42.05 +/- 2.66), and 40 ostensibly healthy individuals, 20 men (41.05 +/- 3.54) and 20 women (43.35 +/- 3.18). Mixed saliva was collected on an empty stomach in the morning, and its glucose, triglyceride, cholesterol, and total protein concentrations were determined. Oxidative status was determined based on biochemiluminescence (BCL) parameters. The chaperone-like activity of saliva was assessed using a model test system based on insulin aggregation suppression. Results: We found a positive correlation between biochemical parameters in saliva and blood serum and between BCL parameters, chaperone-like activity, and blood glucose level. Conclusion: Our findings indicate that saliva can be used as a biomaterial for diagnosing and monitoring the T1DM treatment efficiency.

266-OR: Dexamethasone-Induced Hyperglycemia in Nondiabetic Patients with COVID-19

Background: Dexamethasone improves COVID-outcomes. Detailed glycemic profile for patients receiving dexamethasone for COVID-is lacking. Methods: Our hospital recommends routine blood glucose monitoring for patients with COVID-receiving dexamethasone 6mg daily. Subjects without prior history of diabetes admitted in a non-critical care setting over a 1-month period were identified and evaluated. The primary outcome was hyperglycemia post-dexamethasone, defined as glucose ≥10mmol/L. Results: Of 277 subjects (52% male, age 52±18 yrs, weight 90±26 kg, 7% with newly diagnosed diabetes [HbA1c ≥6.5%]) , hyperglycemia post-dexamethasone occurred in 51%, with peak glucose 12.4±2.3 (mean 2.2 tests/day) . Glucose excursions peaked 7-9 hours post-dexamethasone (figure) . Hyperglycemic subjects were older (58±17 vs. 45±7 yrs, p<0.001) , had higher HbA1c (6.1±1.0 vs. 5.6±0.9%, p<0.001) , higher initial venous glucose (6.7±1.7 vs. 6.0±1.5mmol/L, p<0.001) , lower initial eGFR (80±18 vs. 84±15mL/min/m2, p=0.02) , higher initial CRP (969±640 vs. 791±558nmol/L, p=0.01) and greater mortality (7.7 vs. 1.5%, p=0.01) . Age, HbA1c and CRP were independent predictors of hyperglycemia. Conclusions: Dexamethasone led to hyperglycemia in half of patients without prior diabetes admitted with COVID-19, with peak occurring 7-9 hours after dexamethasone. Older age, higher HbA1c and initial CRP predicted development of hyperglycemia. Disclosure Y.J.Rhou: None. A.Hor: None. M.Wang: None. Y.Wu: None. D.R.Chipps: None. N.Cheung: None.

Electronic blood glucose monitoring impacts on provider and patient behavior.

ObjectiveRecent technological development along with the constraints imposed by the coronavirus disease 2019 (COVID-19) pandemic have led to increased availability of patient-generated health data. However, it is not well understood how to effectively integrate this new technology into large health systems. This article seeks to identify interventions to increase utilization of electronic blood glucose monitoring for patients with diabetes.Materials and MethodsA large randomized controlled trial tested the impact of multiple interventions to promote use of electronic blood glucose tracking. The total study sample consisted of 7052 patients with diabetes across 68 providers at 20 selected primary care offices. The design included 2 stages: First, primary care practices were randomly assigned to have their providers receive education regarding blood glucose flowsheet orders. Then, patients in the treated practices were assigned to 1 of 4 reminder interventions.ResultsProvider education successfully increased provider take-up of an online blood glucose monitoring tool by 64 percentage points, while a comparison of reminder interventions revealed that emphasizing accountability to the provider encouraged patients to track their blood glucose online. An assessment of downstream outcomes revealed impacts of the interventions on prescribing behavior and A1c testing frequency.DiscussionIt is important to understand how health systems can practically promote take-up and awareness of emerging digital health alternatives or those with persistently low utilization in clinical settings.ConclusionThese results indicate that provider training and support are critical first steps to promote utilization of patient-generated health data, and that patient communications can provide further motivation.

Capillary Blood Glucose Monitoring for Patients Receiving Radiotherapy For Primary Brain Tumours Prescribed Dexamethasone

Background: Steroids, in particular dexamethasone are often used to reduce the oedema associated with brain tumours which can be exacerbated during radiotherapy. Prolonged use of dexamethasone in this patient group can result in symptomatic hyperglycaemia including fatigue, polyuria and polydipsia. Prolonged hyperglycaemia can also result in acute complications including risk of infection and metabolic complications. There was no system in place for regular blood glucose monitoring for patients taking dexamethasone and receiving radiotherapy for primary brain tumours at a tertiary cancer centre.

Understanding the Profiles of Blood Glucose Monitoring Among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Shandong, China.

BackgroundBlood glucose monitoring is essential in diabetic care and management. Monitoring using glucometers in home and in laboratories by professionals in certain health institutes were the common methods of blood glucose monitoring in clinical practice. This study aimed to characterize the profiles of blood glucose monitoring in the view of the discrepancy in methods and frequency conducted by the patients with type 2 diabetes mellitus (T2DM) in China, and to explore factors influencing the profiles.MethodsA cross-sectional, community-based study was conducted in Shandong province, China, with a multi-stage stratified sampling. A total of 2166 T2DM patients completed the structured questionnaires about the real-world status of blood glucose monitoring and other questions composed of demographic and clinical characteristic as well as the diabetes-related cognitive scales. Latent profile analysis (LPA) was used to identify the underlying profiles of blood glucose monitoring based on self-reported frequency of blood glucose monitoring through different methods. Univariate and multivariate logistic regression were used to analyze the characteristics of the profiles and to explore the factors associated with it.ResultsAmong the 2166 participants, the mean frequency of blood glucose monitoring was 2.77 times (standard deviation: 7.67) per month. LPA indicated that five-class model was the best solution for classifying the latent groups of blood glucose monitoring: Class 1 “Low frequency in all”, Class 2 “High frequency in hospitals”, Class 3 “High frequency in primary health institutes”, Class 4 “High frequency in pharmacies”, and Class 5 “High frequency in self-monitoring”. The proportions of the patients in class 1, class 2, class 3, class 4, and class 5 were 88.1% (n=1909), 1.3% (n=28), 3.1% (n=67), 6.1% (n=133) and 1.3% (n=29), respectively. Multivariate logistic regression showed that participants who had higher income (OR: 1.58, 95% CI: 1.04~2.41, p<0.05), had diabetes complication(s) (OR=1.37, 95% CI: 1.03~1.02, p=0.03) and had a good knowledge of blood glucose control (OR=1.59, 95% CI: 1.17~2.16, p<0.01) were more likely to have high frequency of blood glucose monitoring (in class 2, 3, 4, 5), and the rural patients were less likely to had high frequency of blood glucose monitoring (OR=0.47, 95% CI: 0.35~0.63, p<0.01).ConclusionLow frequency dominates the characteristics of the profiles of blood glucose monitoring among T2DM patients in China, though distinct blood glucose monitoring groups can be identified by LPA. Educational and financial supports were recommended to increase the frequency of blood glucose monitoring in patients with T2DM, focusing on the patients with low socioeconomic status.

Application of continuous glucose monitoring system in blood glucose monitoring for patients with type 2 diabetes mellitus

Application of continuous glucose monitoring system in blood glucose monitoring for patients with type 2 diabetes mellitus

Qualitative research on compliance of blood glucose monitoring in elderly patients with type 2 diabetes in rural areas

Objective To understand the factors affecting the compliance of blood glucose monitoring in patients with type 2 diabetes in rural areas, and to provide evidence for improving the compliance of patients with blood glucose monitoring. Methods A method of phenomenological study in qualitative research was conducted to conduct deep semi-structured interviews on 43 patients with poor blood glucose compliance in type 2 diabetes in rural areas, and to analyze the collected data. Results Extracted five themes: bad experience affected compliance; lack of knowledge about blood glucose monitoring; economic and time was not sufficient; long-term illness into a good doctor overconfidence; social support uncertainty. Conclusions The status of blood glucose monitoring in rural type 2 diabetes patients is not optimistic. In order to improve the compliance of patients with blood glucose monitoring, nursing workers should pay attention to the mastery of blood glucose monitoring knowledge in rural type 2 diabetes patients, improve blood glucose monitoring methods and techniques, and give full play to the role of family doctors. Efforts to improve patient blood glucose monitoring compliance. Key words: Diabetes, type 2; Blood glucose monitoring; Compliance; Qualitative research

Electronic prompt for capillary blood glucose monitoring in patients admitted for a flare of inflammatory bowel disease increases detection of steroid-induced diabetes

To improve monitoring of capillary blood sugars (CBG) and diagnosis of steroid induced diabetes in patients receiving high dose steroids to treat a flare of inflammatory bowel disease (IBD). Frequency of CBG monitoring for patients admitted with a flare of IBD without a prior diagnosis of diabetes between February–April 2017 was recorded. Following the introduction of an electronic recording system for CBGs a re-audit took place for …

Effects of a Web-Based Self-Management Program on the Behavior and Blood Glucose Levels of Women with Gestational Diabetes Mellitus.

Background:Women diagnosed with gestational diabetes mellitus suffer from anxiety and depression, which make controlling blood glucose levels difficult.Introduction:This quasi-experimental study uses a nonequivalent control group pretest-posttest design to investigate the effects of a web-based self-care program on self-care behaviors, anxiety, depression, and blood glucose in patients with gestational diabetes mellitus.Methods:The subjects of the study were outpatients being treated in the Department of Endocrinology at Hospital G, located in Seoul near University C, from July 15, 2015, to December 31, 2016. The experimental and control groups contained 22 participants each. The experimental group received a 12-week web-based program and one session of nutrition education; the control group received nutrition education. Using the SPSS program, pre-post changes in blood glucose, anxiety, depression, and self-care behaviors were examined between the two groups by a repeated-measures ANOVA.Results:After the 12 weeks intervention, self-care behaviors increased in both groups, and blood glucose monitoring increased in the experimental group (p = 0.001). Anxiety in the experimental group decreased by 5.1 points but increased by 1.0 point in the control group (p = 0.048). Depression increased in both groups. Glycated hemoglobin (HbA1C) levels decreased in the experimental group but increased in the control group (p = 0.001).Discussion:In addition to reducing HbA1C and anxiety, the web-based self-care program was effective in increasing the frequency of daily blood glucose monitoring in patients with gestational diabetes mellitus.Conclusions:This study will be helpful in informing an anxiety intervention program, blood glucose control, and healthy self-care behaviors in women with gestational diabetes mellitus.

Research and analysis on blood glucose monitoring in patients with diabetes during the perioperative period

Objective To explore the status of blood glucose monitoring in patients with diabetes during the perioperative period, and to offer reference for optimizing blood glucose monitoring for patients with diabetes during the perioperative period. Methods The cases of totally 106 patients with diabetes who received selective operation in the First Affiliated Hospital of Nanjing Medical University between June and December 2015 and the relevant data of blood glucose monitoring were retrospectively analyzed. Results The rate of preoperative glycated hemoglobin monitoring in these patients was 33.3%, and the rate of blood glucose monitoring 1 day before operation was 59.4%. The frequency of per capita blood glucose monitoring and the seven-step blood glucose monitoring rate 1 day after operation were greater than those of the operation day (P<0.01) . Both the maximum and minimum values of blood glucose were higher than those of the operation day, the maximum value of blood glucose 1 day after operation was higher than that of the operation day (P<0.05) . Conclusions The rate of preoperative glycated hemoglobin monitoring in these patients is low; the frequency of blood glucose monitoring during the perioperative period is low; and the blood glucose control 1 day after operation is not satisfied. Therefore, clinical nursing staff shall pay attention to these problems. Key words: Perioperative nursing; Diabetes mellitus; Blood glucose monitoring

Blood Glucose Monitoring Before and After Type 1 Diabetes Clinic Visits.

To determine patterns of blood glucose monitoring in children and adolescents with type 1 diabetes (T1D) before and after routine T1D clinic visits. Blood glucose monitoring data were downloaded at four consecutive routine clinic visits from children and adolescents aged 5-18 years. Linear mixed models were used to analyze patterns of blood glucose monitoring in patients who had at least 28 days of data stored in their blood glucose monitors. In general, the frequency of blood glucose monitoring decreased across visits, and younger children engaged in more frequent blood glucose monitoring. Blood glucose monitoring increased before the T1D clinic visits in younger children, but not in adolescents. It declined after the visit regardless of age. Members of the T1D care team need to consider that a T1D clinic visit may prompt an increase in blood glucose monitoring when making treatment changes and recommendations. Tailored interventions are needed to maintain that higher level of adherence across time.

WS21.5 Real life evaluation of the introduction of Freestyle Libre continuous glucose system versus capillary blood glucose monitoring in patients with cystic fibrosis related diabetes

WS21.5 Real life evaluation of the introduction of Freestyle Libre continuous glucose system versus capillary blood glucose monitoring in patients with cystic fibrosis related diabetes

The application of dynamic blood glucose monitoring on patients with insulinoma

Objective To explore the application value of dynamic blood glucose monitoring in the blood glucose monitoring for patients with insulinoma. Methods A total of 16 patients with insulinoma treated in our hospital from October 2013 to December 2015 were taken as the observation group.While 15 cases with hypoglycemia caused by the type 2 diabetic reaction were taken as the diabetic group and 15 cases of normal healthy volunteers as control group.Three groups all received 72 hours dynamic blood glucose monitoring.The general information, the mean value of 24 hours blood glucose, the standard deviation of the blood glucose, the maximum of the blood sugar, the minimum of the blood sugar, the maximum fluctuation range and the frequency and duration of hypoglycemia were compared. Results The BMI index and insulin releasing index of the observation group were significantly higher than that of the diabetic group and the control group (P<0.05). The HbAlc of diabetic group was significantly higher than that of the observation group and control group (t=4.615, 4.273, P<0.05), while the MAD of the diabetic group was significantly lower than that of the observation group and control group (t=5.124, 5.238, P<0.05). The 72-hour starvation-exercise test found 13 positive cases and 3 negative cases in the observation group.The average blood glucose and blood glucose of the observation group were (4.69 + 1.53) mmol/L and (2.46 + 0.29) mmol/L respectively, which were significantly lower than that of the diabetic group and the control group (P<0.05). The maximum blood glucose level and the maximum fluctuation range of the observation group were significantly lower than that of the diabetic group, which were significantly higher than that of the control group (P<0.05). The frequency of hypoglycemia of observation group was significantly higher than that of the diabetic group and the duration of hypoglycemia was significantly longer than that of the diabetic group (P<0.05). Conclusion Dynamic blood glucose monitoring can better reflect the dynamic changes of blood glucose of patients with insulinoma, which shows a strong application value. Key words: Insulinoma; Blood glucose monitoring; Dynamic blood glucose monitoring; Application value

Retrospective review of the incidence of monitoring blood glucose levels in patients receiving corticosteroids with systemic anticancer therapy.

Corticosteroids are used adjuvant to certain chemotherapy regimens, either as an antiemetic, to reduce other side effects, or to enhance cancer treatment. Additionally, they are frequently used for symptom control in cancer patients with end stage disease. Corticosteroid use may induce hyperglycemia in approximately 20-50% of patients, which may negatively affect patient outcomes. To determine the frequency of blood glucose monitoring in patients with and without diabetes receiving continuous corticosteroids with chemotherapy, and to determine the incidence of treatment-emergent abnormal blood glucose levels and steroid-induced diabetes mellitus (DM). A retrospective review was conducted for 30 genitourinary (GU) cancer patients who were treated with continuous oral corticosteroids as part of their chemotherapy regimen. The Canadian Diabetes Association (CDA) criterion for diagnosis of diabetes was applied to categorize patients into two distinct groups, patients with diabetes and patients without diabetes. This categorization was made based on glucose measurements completed prior to commencement of corticosteroid therapy. Glucose monitoring was defined as receiving a laboratory blood glucose test before first chemotherapy administration along with a test within a week of each subsequent treatment cycle. The CDA criteria for diagnosis of pre-diabetes and diabetes was used to classify glucose levels as hyperglycemic. The mean incidence of blood glucose monitoring was 19% and 76% in patients with diabetes and patients without diabetes, respectively. Approximately, 40% of patients with diabetes required an adjustment to their diabetes management and a further 20% required hospitalization. Fifteen patients without diabetes received a fasting blood glucose test, of which 40% had abnormal blood glucose results; half of these fell into the pre-diabetic range and half in the diabetic range. Ten patients without diabetes were tested for diabetes using the CDA criteria for diabetes diagnosis during or after their chemotherapy, of which 30% developed diabetes. In order to optimize patient care, blood glucose levels should be monitored in all patients receiving continuous oral corticosteroids as part of their chemotherapy. Future studies should be conducted prospectively to determine the most effective manner of monitoring in order to implement screening guidelines and avoid unnecessary morbidity.

Changes in Insulin Clearance During Sunitinib Treatment

ABSTRACT Aim: Sunitinib, a VEGFR tyrosine kinase inhibitor (TKI) is registered in metastatic renal cell carcinoma (mRCC), gastrointestinal stromal tumor (GIST) and pancreatic neuroendocrine tumors. In patients with diabetes who were treated with sunitinib, a decrease in blood glucose levels and symptomatic hypoglycemias have been reported. Some preclinical studies suggest that improved insulin sensitivity may be the underlying mechanism. Therefore we studied the early effects of sunitinib on insulin sensitivity and insulin steady-state concentrations. Methods: In 10 mRCC patients, after an overnight fast, a 120 minutes hyperinsulinemic euglycemic clamp (insulin infusion rate 60 mE.m-2.min-1; steady state 90-120 minutes) was performed before and one week (7-10 days) after start of sunitinib 50mg per day. Insulin levels were measured using a radio-immune assay. Insulin sensitivity index (SI) was defined as glucose disposal rate normalized for steady state blood glucose concentration divided by the steady-state plasma insulin. Results: One patient with diabetes (treated with metformin) and 9 patients without diabetes were included in the study protocol (Female/Male: 1/9). Co-medication did not change during the study. The insulin sensitivity index decreased from 0.22 ± 0.04 µmol/kg-1 . min-1 .(mE insulin/L)-1 before to 0.18 ± 0.02 µmol/kg-1 . min-1 . (mE insulin /L)-1 (p Conclusions: Sunitinib increased steady-state insulin concentrations by 30% most likely as a result of impaired insulin clearance. In our study group, mostly without diabetes, insulin sensitivity decreased. These alterations were already observed as early as one week on sunitinib treatment. In patients using insulin or insulin-secretion stimulating agents the effect of sunitinib on insulin clearance could result in overexposure to insulin and thereby induce hypoglycemia. Intense blood glucose monitoring in patients with diabetes is therefore essential in the first week after starting sunitinib. Disclosure: All authors have declared no conflicts of interest.

Parsimonious Model for Blood Glucose Level Monitoring in Type 2 Diabetes patients

To establish the parsimonious model for blood glucose monitoring in patients with type 2 diabetes receiving oral hypoglycemic agent treatment. One hundred and fifty-nine adult Chinese type 2 diabetes patients were randomized to receive rapid-acting or sustained-release gliclazide therapy for 12 weeks. Their blood glucose levels were measured at 10 time points in a 24 h period before and after treatment, and the 24 h mean blood glucose levels were measured. Contribution of blood glucose levels to the mean blood glucose level and HbA1c was assessed by multiple regression analysis. The correlation coefficients of blood glucose level measured at 10 time points to the daily MBG were 0.58-0.74 and 0.59-0.79, respectively, before and after treatment (P<0.0001). The multiple stepwise regression analysis showed that the blood glucose levels measured at 6 of the 10 time points could explain 95% and 97% of the changes in MBG before and after treatment. The three blood glucose levels, which were measured at fasting, 2 h after breakfast and before dinner, of the 10 time points could explain 84% and 86% of the changes in MBG before and after treatment, but could only explain 36% and 26% of the changes in HbA1c before and after treatment, and they had a poorer correlation with the HbA1c than with the 24 h MBG. The blood glucose levels measured at fasting, 2 h after breakfast and before dinner truly reflected the change 24 h blood glucose level, suggesting that they are appropriate for the self-monitoring of blood glucose levels in diabetes patients receiving oral anti-diabetes therapy.

Optimal Time for Capillary Blood Glucose Monitoring in Patients with Type 2 Diabetes Treated with Insulin: A Cross-Sectional Observation Study

Our objective was to determine the frequency and time of day when we detect the greatest number of hyperglycaemic and hypoglycaemic episodes in patients with type 2 diabetes mellitus (DM) on insulin. We also studied whether any clinical feature could be associated with more frequent hypoglycaemia or hyperglycaemia. We conducted an observational study of 51 patients with type 2 diabetes mellitus who were on insulin and metabolically stable. We followed the patients for 8 weeks, performing two daily capillary blood glucose measurements before and 2 hours after each of the three main meals in turn. A profile was also prepared from 6 capillary blood glucose measurements performed before and after meals every 4 days. The likelihood of observing hyperglycaemia increased 48% before dinner (taking pre-breakfast capillary blood glucose as a reference). The likelihood of observing hypoglycaemia was 3.4 times greater in pre-lunch capillary blood glucose measurements and was more frequent in patients with lower BMI. In patients with type 2 DM stabilised by insulin, performing pre-dinner capillary blood glucose measurements identifies hyperglycaemia more often than at other times of the day, while pre-lunch measurement identifies hypoglycaemia more often, the latter being more common in patients with lower BMI.