Cargando…

Improvement in Glucose Regulation Using a Digital Tracker and Continuous Glucose Monitoring in Healthy Adults and Those with Type 2 Diabetes

INTRODUCTION: While continuous glucose monitoring (CGM) has been shown to decrease both hyper- and hypoglycemia in insulin-treated diabetes, its value in non-insulin-treated type 2 diabetes (T2D) and prediabetes is unclear. Studies examining the reduction in hyperglycemia with the use of CGM in non-...

Descripción completa

Detalles Bibliográficos
Autores principales: Dehghani Zahedani, Ashkan, Shariat Torbaghan, Solmaz, Rahili, Salar, Karlin, Kirill, Scilley, Darrin, Thakkar, Riya, Saberi, Maziyar, Hashemi, Noosheen, Perelman, Dalia, Aghaeepour, Nima, McLaughlin, Tracey, Snyder, Michael P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266934/
https://www.ncbi.nlm.nih.gov/pubmed/34047962
http://dx.doi.org/10.1007/s13300-021-01081-3
_version_ 1783720038059999232
author Dehghani Zahedani, Ashkan
Shariat Torbaghan, Solmaz
Rahili, Salar
Karlin, Kirill
Scilley, Darrin
Thakkar, Riya
Saberi, Maziyar
Hashemi, Noosheen
Perelman, Dalia
Aghaeepour, Nima
McLaughlin, Tracey
Snyder, Michael P.
author_facet Dehghani Zahedani, Ashkan
Shariat Torbaghan, Solmaz
Rahili, Salar
Karlin, Kirill
Scilley, Darrin
Thakkar, Riya
Saberi, Maziyar
Hashemi, Noosheen
Perelman, Dalia
Aghaeepour, Nima
McLaughlin, Tracey
Snyder, Michael P.
author_sort Dehghani Zahedani, Ashkan
collection PubMed
description INTRODUCTION: While continuous glucose monitoring (CGM) has been shown to decrease both hyper- and hypoglycemia in insulin-treated diabetes, its value in non-insulin-treated type 2 diabetes (T2D) and prediabetes is unclear. Studies examining the reduction in hyperglycemia with the use of CGM in non-insulin-treated T2D are limited. METHODS: We investigated the potential benefit of CGM combined with a mobile app that links each individual’s glucose tracing to meal composition, heart rate, and physical activity in a cohort of 1022 individuals, ranging from nondiabetic to non-insulin-treated T2D, spanning a wide range of demographic, geographic, and socioeconomic characteristics. The primary endpoint was the change in time in range (TIR), defined as 54–140 mg/dL for healthy and prediabetes, and 54–180 mg/dL for T2D, from the beginning to end of a 10-day period of use of the Freestyle Libre CGM. Logged food intake, physical activity, continuous glucose, and heart rate data were captured by a smartphone-based app that continuously provided feedback to participants, overlaying daily glucose patterns with activity and food intake, including macronutrient breakdown, glycemic load (GL), and glycemic index (GI). RESULTS: A total of 665 participants meeting eligibility and data requirements were included in the final analysis. Among self-reported nondiabetic participants, CGM identified glucose excursions in the diabetic range among 15% of healthy and 36% of those with prediabetes. In the group as a whole, TIR improved significantly (p < 0.001). Among the 51.4% of participants who improved, TIR increased by an average of 6.4% (p < 0.001). Of those with poor baseline TIR, defined as TIR below comparable A1c thresholds for T2D and prediabetes, 58.3% of T2D and 91.7% of healthy/prediabetes participants improved their TIR by an average of 22.7% and 23.2%, respectively. Predictors of improved response included no prior diagnosis of T2D and lower BMI. CONCLUSIONS: These results indicate that 10-day use of CGM as a part of multimodal data collection, with synthesis and feedback to participants provided by a mobile health app, can significantly reduce hyperglycemia in non-insulin-treated individuals, including those with early stages of glucose dysregulation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13300-021-01081-3.
format Online
Article
Text
id pubmed-8266934
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Springer Healthcare
record_format MEDLINE/PubMed
spelling pubmed-82669342021-07-20 Improvement in Glucose Regulation Using a Digital Tracker and Continuous Glucose Monitoring in Healthy Adults and Those with Type 2 Diabetes Dehghani Zahedani, Ashkan Shariat Torbaghan, Solmaz Rahili, Salar Karlin, Kirill Scilley, Darrin Thakkar, Riya Saberi, Maziyar Hashemi, Noosheen Perelman, Dalia Aghaeepour, Nima McLaughlin, Tracey Snyder, Michael P. Diabetes Ther Original Research INTRODUCTION: While continuous glucose monitoring (CGM) has been shown to decrease both hyper- and hypoglycemia in insulin-treated diabetes, its value in non-insulin-treated type 2 diabetes (T2D) and prediabetes is unclear. Studies examining the reduction in hyperglycemia with the use of CGM in non-insulin-treated T2D are limited. METHODS: We investigated the potential benefit of CGM combined with a mobile app that links each individual’s glucose tracing to meal composition, heart rate, and physical activity in a cohort of 1022 individuals, ranging from nondiabetic to non-insulin-treated T2D, spanning a wide range of demographic, geographic, and socioeconomic characteristics. The primary endpoint was the change in time in range (TIR), defined as 54–140 mg/dL for healthy and prediabetes, and 54–180 mg/dL for T2D, from the beginning to end of a 10-day period of use of the Freestyle Libre CGM. Logged food intake, physical activity, continuous glucose, and heart rate data were captured by a smartphone-based app that continuously provided feedback to participants, overlaying daily glucose patterns with activity and food intake, including macronutrient breakdown, glycemic load (GL), and glycemic index (GI). RESULTS: A total of 665 participants meeting eligibility and data requirements were included in the final analysis. Among self-reported nondiabetic participants, CGM identified glucose excursions in the diabetic range among 15% of healthy and 36% of those with prediabetes. In the group as a whole, TIR improved significantly (p < 0.001). Among the 51.4% of participants who improved, TIR increased by an average of 6.4% (p < 0.001). Of those with poor baseline TIR, defined as TIR below comparable A1c thresholds for T2D and prediabetes, 58.3% of T2D and 91.7% of healthy/prediabetes participants improved their TIR by an average of 22.7% and 23.2%, respectively. Predictors of improved response included no prior diagnosis of T2D and lower BMI. CONCLUSIONS: These results indicate that 10-day use of CGM as a part of multimodal data collection, with synthesis and feedback to participants provided by a mobile health app, can significantly reduce hyperglycemia in non-insulin-treated individuals, including those with early stages of glucose dysregulation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13300-021-01081-3. Springer Healthcare 2021-05-28 2021-07 /pmc/articles/PMC8266934/ /pubmed/34047962 http://dx.doi.org/10.1007/s13300-021-01081-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Dehghani Zahedani, Ashkan
Shariat Torbaghan, Solmaz
Rahili, Salar
Karlin, Kirill
Scilley, Darrin
Thakkar, Riya
Saberi, Maziyar
Hashemi, Noosheen
Perelman, Dalia
Aghaeepour, Nima
McLaughlin, Tracey
Snyder, Michael P.
Improvement in Glucose Regulation Using a Digital Tracker and Continuous Glucose Monitoring in Healthy Adults and Those with Type 2 Diabetes
title Improvement in Glucose Regulation Using a Digital Tracker and Continuous Glucose Monitoring in Healthy Adults and Those with Type 2 Diabetes
title_full Improvement in Glucose Regulation Using a Digital Tracker and Continuous Glucose Monitoring in Healthy Adults and Those with Type 2 Diabetes
title_fullStr Improvement in Glucose Regulation Using a Digital Tracker and Continuous Glucose Monitoring in Healthy Adults and Those with Type 2 Diabetes
title_full_unstemmed Improvement in Glucose Regulation Using a Digital Tracker and Continuous Glucose Monitoring in Healthy Adults and Those with Type 2 Diabetes
title_short Improvement in Glucose Regulation Using a Digital Tracker and Continuous Glucose Monitoring in Healthy Adults and Those with Type 2 Diabetes
title_sort improvement in glucose regulation using a digital tracker and continuous glucose monitoring in healthy adults and those with type 2 diabetes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266934/
https://www.ncbi.nlm.nih.gov/pubmed/34047962
http://dx.doi.org/10.1007/s13300-021-01081-3
work_keys_str_mv AT dehghanizahedaniashkan improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT shariattorbaghansolmaz improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT rahilisalar improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT karlinkirill improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT scilleydarrin improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT thakkarriya improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT saberimaziyar improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT hasheminoosheen improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT perelmandalia improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT aghaeepournima improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT mclaughlintracey improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes
AT snydermichaelp improvementinglucoseregulationusingadigitaltrackerandcontinuousglucosemonitoringinhealthyadultsandthosewithtype2diabetes