Cargando…

Glucose Variability Assessed by Low Blood Glucose Index Is Predictive of Hypoglycemic Events in Patients With Type 1 Diabetes Switched to Pump Therapy

OBJECTIVE: To determine whether subgroups of type 1 diabetic patients with different glucose variability indices respond differently to continuous subcutaneous insulin infusion (CSII) in terms of reduced hypoglycemic events. RESEARCH DESIGN AND METHODS: We studied 50 adults with long-standing type 1...

Descripción completa

Detalles Bibliográficos
Autores principales: Crenier, Laurent, Abou-Elias, Charlotte, Corvilain, Bernard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714507/
https://www.ncbi.nlm.nih.gov/pubmed/23404296
http://dx.doi.org/10.2337/dc12-2058
_version_ 1782277369236553728
author Crenier, Laurent
Abou-Elias, Charlotte
Corvilain, Bernard
author_facet Crenier, Laurent
Abou-Elias, Charlotte
Corvilain, Bernard
author_sort Crenier, Laurent
collection PubMed
description OBJECTIVE: To determine whether subgroups of type 1 diabetic patients with different glucose variability indices respond differently to continuous subcutaneous insulin infusion (CSII) in terms of reduced hypoglycemic events. RESEARCH DESIGN AND METHODS: We studied 50 adults with long-standing type 1 diabetes switched to CSII because of persistently high A1C or frequent hypoglycemia despite well-managed intensive basal-bolus therapy. We compared A1C, hypoglycemic events, and glucose variability from self-monitoring of blood glucose profiles at baseline and after 6 months of CSII. Regression analysis was performed to identify predictors of response. RESULTS: In multivariate analysis, baseline low blood glucose index (LBGI) was the best independent predictor of hypoglycemia outcome on CSII (R(2) = 0.195, P = 0.0013). An ROC curve analysis demonstrated a sensitivity of 70.8% (95% CI 48.9–87.4) and specificity of 73.1% (52.2–88.4) by using the LBGI cutoff of 3.34 as predictor of reduction of hypoglycemia on CSII. By grouping patients by LBGI tertiles, we found a 23.3% reduction in hypoglycemic events (<60 mg/dL [3.3 mmol/L]) in the third tertile (range 4.18–9.34) without change in A1C (P < 0.05). Conversely, the first tertile (range 0.62–2.05) demonstrated the greatest A1C reduction, −0.99% (P = 0.00001), but with increasing hypoglycemia. CONCLUSIONS: Baseline LBGI predicts the outcome of type 1 diabetic patients who switch to CSII in terms of hypoglycemia.
format Online
Article
Text
id pubmed-3714507
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher American Diabetes Association
record_format MEDLINE/PubMed
spelling pubmed-37145072014-08-01 Glucose Variability Assessed by Low Blood Glucose Index Is Predictive of Hypoglycemic Events in Patients With Type 1 Diabetes Switched to Pump Therapy Crenier, Laurent Abou-Elias, Charlotte Corvilain, Bernard Diabetes Care Original Research OBJECTIVE: To determine whether subgroups of type 1 diabetic patients with different glucose variability indices respond differently to continuous subcutaneous insulin infusion (CSII) in terms of reduced hypoglycemic events. RESEARCH DESIGN AND METHODS: We studied 50 adults with long-standing type 1 diabetes switched to CSII because of persistently high A1C or frequent hypoglycemia despite well-managed intensive basal-bolus therapy. We compared A1C, hypoglycemic events, and glucose variability from self-monitoring of blood glucose profiles at baseline and after 6 months of CSII. Regression analysis was performed to identify predictors of response. RESULTS: In multivariate analysis, baseline low blood glucose index (LBGI) was the best independent predictor of hypoglycemia outcome on CSII (R(2) = 0.195, P = 0.0013). An ROC curve analysis demonstrated a sensitivity of 70.8% (95% CI 48.9–87.4) and specificity of 73.1% (52.2–88.4) by using the LBGI cutoff of 3.34 as predictor of reduction of hypoglycemia on CSII. By grouping patients by LBGI tertiles, we found a 23.3% reduction in hypoglycemic events (<60 mg/dL [3.3 mmol/L]) in the third tertile (range 4.18–9.34) without change in A1C (P < 0.05). Conversely, the first tertile (range 0.62–2.05) demonstrated the greatest A1C reduction, −0.99% (P = 0.00001), but with increasing hypoglycemia. CONCLUSIONS: Baseline LBGI predicts the outcome of type 1 diabetic patients who switch to CSII in terms of hypoglycemia. American Diabetes Association 2013-08 2013-07-11 /pmc/articles/PMC3714507/ /pubmed/23404296 http://dx.doi.org/10.2337/dc12-2058 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Crenier, Laurent
Abou-Elias, Charlotte
Corvilain, Bernard
Glucose Variability Assessed by Low Blood Glucose Index Is Predictive of Hypoglycemic Events in Patients With Type 1 Diabetes Switched to Pump Therapy
title Glucose Variability Assessed by Low Blood Glucose Index Is Predictive of Hypoglycemic Events in Patients With Type 1 Diabetes Switched to Pump Therapy
title_full Glucose Variability Assessed by Low Blood Glucose Index Is Predictive of Hypoglycemic Events in Patients With Type 1 Diabetes Switched to Pump Therapy
title_fullStr Glucose Variability Assessed by Low Blood Glucose Index Is Predictive of Hypoglycemic Events in Patients With Type 1 Diabetes Switched to Pump Therapy
title_full_unstemmed Glucose Variability Assessed by Low Blood Glucose Index Is Predictive of Hypoglycemic Events in Patients With Type 1 Diabetes Switched to Pump Therapy
title_short Glucose Variability Assessed by Low Blood Glucose Index Is Predictive of Hypoglycemic Events in Patients With Type 1 Diabetes Switched to Pump Therapy
title_sort glucose variability assessed by low blood glucose index is predictive of hypoglycemic events in patients with type 1 diabetes switched to pump therapy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714507/
https://www.ncbi.nlm.nih.gov/pubmed/23404296
http://dx.doi.org/10.2337/dc12-2058
work_keys_str_mv AT crenierlaurent glucosevariabilityassessedbylowbloodglucoseindexispredictiveofhypoglycemiceventsinpatientswithtype1diabetesswitchedtopumptherapy
AT aboueliascharlotte glucosevariabilityassessedbylowbloodglucoseindexispredictiveofhypoglycemiceventsinpatientswithtype1diabetesswitchedtopumptherapy
AT corvilainbernard glucosevariabilityassessedbylowbloodglucoseindexispredictiveofhypoglycemiceventsinpatientswithtype1diabetesswitchedtopumptherapy