Thus, elderly patients with diabetes require treatments that can prevent diabetic complications by stabilizing glycemic variability (GV) without hypoglycemia . The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study ... (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. It is well accepted that hyperglycemia in diabetes directly contributes to short/long-term microvascular complications and has a long-term role in the development of macrovascular disease. It is important to use the least insulin dose, with the target of minimizing glycemic variability, to achieve good glycemic control without hypoglycemia. The diaTribe Foundation is pleased to share the Glycemic Outcomes Beyond A1c Resources page, which includes coverage of the July gathering and the meetings leading up to "Glycemic Outcomes Beyond A1C", materials from the day (i.e. Glycemic variability and hypoglycemia duration were assessed from continuous glucose monitoring data recorded over 6 consecutive days. Patients were studied before RYGB (Pre) and 1 month, 1 year, and 2 years postsurgery with continuous glucose … Among diabetic cats with hypoglycemia, 33 (25%) had PHH. The study objective was to establish RYGB’s effects on glycemic variability (GV) and hypoglycemia. When glycemic variability or hyperglycemia was … Although it remains yet no consensus, accumulating evidence has suggested that GV, representing either short-term (with-day and between-day variability) or long-term GV, was … The … These are benefits that might be further enhanced with integration of diet and exercise and perhaps translate to PX patients; … Treatment of hypoglycemia with dextrose 50% can overcorrect blood glucose levels and increase glucose variability. Hyperglycemia. In addition, severe hypoglycemia was found to be associated with dementia , cardiovascular diseases and mortality risk in these patients. Hyperglycemia with high variability and occurrence of hypoglycemia showed a higher GDI value than the same condition without hypoglycemia, even though the MBG and eHbA1c values were at lower levels (A vs. B), indicating that hypoglycemia is an influential factor in increasing glycemic deviation in our formula. Hypoglycemia also yielded the highest RR for the need for RRT. glycemic variability and hypoglycemia The hypothesis that the maintenance of close glycemic control is of importance in all of the clinical settings is highlighted by the recent evidence that in individuals with normal glucose tolerance, glycemia is maintained within a narrow range between 68.4 and 138.6 mg/dL [ 50 ]. Results. The determination of clinical variables, such as GFR <45 mL/min, HbA1C >9% and hypoglycemia history, was associated with a high GV. In young adults with type 1 diabetes, self-reported fear of hypoglycemia was associated with greater glycemic variability, increased calorie intake and reduced physical activity, study findings show. Lastly, blockade of GLP-1R signaling prevents falls in the glucose nadir but does not improve glycemic variability. We found that VSG increases glycemic variability, and specifically in response to a mixed-meal liquid gavage, hypoglycemia is readily detectable. The relationship between glucose variability and hypoglycemia … We carried out continuous glucose monitoring in 281 outpatients with type 2 diabetes mellitus who participated in a multicenter cohort (Hyogo Diabetes Hypoglycemia Cognition Complications) study. The study objective was to establish RYGB's effects on glycemic variability (GV) and hypoglycemia. 5,7 Several mechanisms … Although higher individualized HbA1c targets are perceived to reduce the risk of hypoglycemia in those at risk of hypoglycemia, HbA1c itself is a poor predictor of hypoglycemia. Gardner; Suresh Rama … Hyperglycemia, hypoglycemia, and glycemic variability (GV) have been linked to adverse clinical outcomes, which will be briefly discussed below. Association of Glycemic Indices (Hyperglycemia, Glucose Variability, and Hypoglycemia) with Oxidative Stress and Diabetic Complications. We carried out continuous glucose monitoring in 281 outpatients with type 2 diabetes mellitus who participated in a multicenter cohort (Hyogo Diabetes Hypoglycemia Cognition Complications) study. Materials and Methods. iate the effect of intensive glycemic control with renal transplant outcomes have not been identified. Glycemic variability (GV), defined as an integral component of glucose homoeostasis, is emerging as an important metric to consider when assessing glycemic control in clinical practice. The … glycemic variability and glycemic indices in predicting hypoglycemia 9 Downloaded by National University of Singapore NUS SWETS/24793917 from www.liebertpub.com at 04/24/18. It has been demonstrated that increased glucose variability is a predictor of hypoglycemia, which is the main limiting factor for achieving the recommended HbA1c target. Crit Care 2008, 12: R129. Lee 4, J.-d. Wu 1 & J.-h. Ma 1 Journal of Endocrinological Investigation volume 41, pages 539–547 (2018)Cite this article Hypoglycemia is a common condition in the neonatal population ().It has a significant prevalence in at risk infants, with that of 47% in large-for-gestational age (LGA) infants, 52% in small-for-gestational age (SGA) infants, 48% in neonates of diabetic mothers, and 54% in late preterm infants ().In infants born before 33 weeks, the prevalence of hypoglycemia is nearly … Risk of hypoglycemia and improved glycemic control. A1C may also inform the accuracy of the patient's CGM or meter … This was a prospective observational study of 10 participants with obesity and prediabetes or type 2 diabetes who underwent RYGB. Results: … For personal use only. We assessed the use of glycemic variability (GV) and glycemic indices as independent predictors of hypoglycemia. An excess of highs and lows in blood sugar is referred to as “glycemic variability” and can be harmful beyond the presence of highs and lows. OBJECTIVE To evaluate the respective contributions of short-term glycemic variability and mean daily glucose (MDG) concentration to the risk of hypoglycemia in type 1 diabetes. A downward trend in blood levels of glucose is evident; levels of HbA 1c (estimated by the use of a linear formula) decreased from 9.4% at baseline to 7.5% by the end of the observation period. Waeschle RM, Moerer O, Hilgers R, Herrmann P, Neumann P, Quintel M: The impact of the severity of sepsis on the risk of hypoglycemia and glycemic variability. Glycemic variability was assessed by calculating mean Coefficient of Variation (CV). Diabetes mellitus is the major risk factor for the development of macrovascular and microvascular complications. Glycemic variability is another factor that likely contributes to complications of diabetes, including negative effects on mood and cognition, as well as the risk of hypoglycemia. Methods A secondary data analysis of 93 participants (n=44 intensive, n=49 control) was conducted using data from a previous randomized controlled clinical trial. Secondary analyses from the DEVOTE trial comparing the ultralong-acting insulin degludec with insulin glargine examine associations between glycemic variability and severe hypoglycemia and outcomes. Hypoglycemia was defined as BG ≤70 mg/dl (3.9 mmol/L) or BG <54 mg/dl (3.0 mmol/L). GV is also a marker of the instability of a person’s metabolic system, expressed as frequent high and low glucose excursions and overall volatile glycemic control. Materials and Methods. Self-monitored blood levels of glucose recorded over 60 days. Gaps in knowledge exist related to the association of FOH and glycemic variability; CGM technology allows examination of these relationships. Although there are not yet enough data to offer guidelines for glycemic variability, a good rule of thumb is an SD that is less than half of the average blood glucose level. ABSTRACT Objective Observations in real-world settings support and extend findings demonstrated in randomized controlled trials that show … We examined inflammatory biomarkers, glycemic variability, hypoglycemia, and hyperglycemia as potential … Our data suggest that the use of technology and treatments able to reduce glycemic variability could be useful in this population to reduce the risk of hypoglycemia and to improve glycemic control. Glycemic variability was calculated as the standard deviation of the blood glucose concentrations. agenda, presentations, patient video), notable journal articles written on glycemic variability, hypoglycemia, future clinical … glycemic variability and hypoglycemia: real-world data from Spain ... glycemic variability glucometrics obtained from CGM can be used as clinical and research variables of gly-cemic control and acute and chronic complication risk. Compared with cats without PHH, their daily insulin … The effects of add-on exenatide to insulin on glycemic variability and hypoglycemia in patients with type 1 diabetes mellitus. Glycaemic variability is currently defined by a large and … Background: Little information is available about posthypoglycemic hyperglycemia (PHH) in diabetic cats, and a causal link between hypoglycemia and subsequent hyperglycemia is not clear. 10.1186/cc7097. Various mechanisms associated with hyperglycemia, such as the production of AGEs, the activation of PKC, the accumulation of sorbitol, and the hyperactivity of the hexosamine pathway, lead to reactive oxygen species overproduction and a decrease in the … Glycemic variability. Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, … Notable differences were observed within and between groups (Supplementary Table 3). RESEARCH DESIGN AND METHODS People with type 1 diabetes (n = 100) investigated at the University Hospital of Montpellier (France) underwent continuous glucose monitoring (CGM) on two … Among diabetic cats with hypoglycemia, 33 (25%) had PHH. OBJECTIVE Roux-en-Y gastric bypass (RYGB) is an established treatment for type 2 diabetes and obesity. Fluctuations in blood glucose concentrations might only represent high glycemic variability. Hypoglycemia and glucose variability are independently associated with increased mortality in septic, surgical, and mixed intensive care unit (ICU) patients. Glycaemic variability is an integral component of glucose homoeostasis. L.-l. Jiang 1 na1, S.-q. Fear of hypoglycemia (FOH) is a barrier to attaining optimal glucose control that may trigger behaviors that contribute to greater glycemic variability in T1DM. Wang 2 na1, B. Ding 1, J. Zhu 1, T. Jing 1, L. Ye 3, K.-O. These responses were seen very early after surgery and therefore offer an experimental model of PBH that could … However, the SGO group had a higher incidence of hypoglycemia (median, 3.5%) than DO group (both fasting and non-fasting periods, p < 0.05 for both), HC (fasting, p < 0.05), and the SGD group (fasting, p < 0.05). Hypothesis: Insulin induces PHH in healthy cats, and PHH is associated with poorly regulated … However, glucose variability remained relatively unchanged from … In this review, the author discusses topics related to the assessment, … Glycemic variability (GV) a well-established risk factor for hypoglycemia and a suspected risk factor for diabetes complications. Results. Beyond HbA1c: Comparing Glycemic Variability and Glycemic Indices in Predicting Hypoglycemia in Type 1 and Type 2 Diabetes. A1C does not provide a measure of glycemic variability or hypoglycemia. We investigated the relationships between TIR, glycemic variability and patient characteristics in patients with type 2 diabetes mellitus. It is increasingly recognized that glycemic variability (GV), referring to oscillations in blood glucose levels and representing either short-term or long-term GV, is involved in the pathogenesis of diabetic complications and has emerged as a possible … All three glycemic indices (hyperglycemia, glycemic variability, and hypoglycemia) have been associated with ROS production. PMID: 29293363 [Indexed for MEDLINE] MeSH terms. Introduction. HbA1c variability is independent of mean HbA1c, and associated with mortality due to vascular complications. RESEARCH DESIGN AND METHODS. Glycemic variability was calculated as the standard deviation of the blood glucose concentrations. is corrected by. Aged; Aged, 80 and over; Blood Glucose/analysis* Blood Glucose Self-Monitoring* Cross-Sectional Studies ; Diabetes Mellitus, Type 2/blood* Diabetes Mellitus, Type 2/drug … Hypoglycemia was the parameter with the highest RR for mortality, followed by hyperglycemia and glycemic variability. We investigated the relationships between TIR, glycemic variability and patient characteristics in patients with type 2 diabetes mellitus. Fasting c-peptide and fasting glucose were measured … Results: In healthy cats, all insulin doses caused hypoglycemia but PHH was not observed; glycemic variability did not differ between insulin preparations. However, the significance of HbA1c variability is unknown at present. RESEARCH DESIGN AND METHODS This was a prospective observational study of 10 participants with obesity and prediabetes or type 2 diabetes who underwent RYGB. Glycemic variability refers to swings in blood glucose levels; it means the oscillations that occur throughout the day, including episodes of hypoglycemia and postprandial hyperglycemia.13 26 27 Clinical data on GV assess short-term—both intraday and day-to-day GV—as well as long-term GV based on fluctuations in blood glucose after weeks or months assessed by HbA1c, SMBG and …

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