Dataset Information

Variation of interstitial glucose measurements assessed by continuous glucose monitors in healthy, nondiabetic individuals.

ABSTRACT:

Objective

To characterize glucose levels during daily living using continuous glucose monitors (CGMs) in nondiabetic individuals.

Research design and methods

Seventy-four healthy children, adolescents, and adults aged 9-65 years with normal glucose tolerance used a blinded CGM device for 3 to 7 days.

Results

Sensor glucose concentrations were 71-120 mg/dl for 91% of the day. Sensor values were 140 mg/dl for only 0.2% and 0.4% of the day, respectively. Sensor glucose concentrations were slightly higher in children than adults (P = 0.009) and were slightly lower during the night than day (95 vs. 99 mg/dl, P < 0.001).

Conclusions

Glucose values 140 mg/dl, measured with CGM, are uncommon in healthy, nondiabetic individuals. CGM may be useful to evaluate glucose tolerance in nondiabetic individuals over time. Furthermore, these data provide a basis for comparison for studies that use CGM to assess glucose control in subjects with diabetes.

SUBMITTER: Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group

PROVIDER: S-EPMC2875442 | biostudies-literature | 2010 Jun

REPOSITORIES: biostudies-literature

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Publications

Variation of interstitial glucose measurements assessed by continuous glucose monitors in healthy, nondiabetic individuals.

Fox Larry A LA Beck Roy W RW Xing Dongyuan D

Diabetes care 20100309 6

<h4>Objective</h4>To characterize glucose levels during daily living using continuous glucose monitors (CGMs) in nondiabetic individuals.<h4>Research design and methods</h4>Seventy-four healthy children, adolescents, and adults aged 9-65 years with normal glucose tolerance used a blinded CGM device for 3 to 7 days.<h4>Results</h4>Sensor glucose concentrations were 71-120 mg/dl for 91% of the day. Sensor values were <or=60 or >140 mg/dl for only 0.2% and 0.4% of the day, respectively. Sensor gluc ...[more]

PMID: 20215454

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Project description:BackgroundContinuous glucose monitors (CGMs) provide high-frequency information regarding daily glucose variation and are recognised as effective for improving glycaemic control in individuals living with diabetes. Despite increased use in individuals with non-diabetic blood glucose concentrations (euglycemia), their utility as a health tool in this population remains unclear.ObjectivesTo characterise variation in time in range (TIR) and glycaemic variability in large populations without diabetes or impaired glucose tolerance; describe associations between CGM-derived glycaemic metrics and metabolic and cardiometabolic health traits; identify key diet and lifestyle factors associated with TIR and glycaemic variability.DesignGlycaemic variability (coefficient of variation) and time spent in both the ADA secondary target range (TIRADA; 3.9-7.8 mmol/L) and a more stringent range (TIR3.9-5.6; 3.9-5.6 mmol/L) were calculated during free-living in PREDICT 1, PREDICT 2, and PREDICT 3 euglycaemic community-based volunteer cohorts. Associations between CGM derived glycaemic metrics, markers of cardiometabolic health, diet (food frequency questionnaire and logged diet records), diet-habits, and lifestyle were explored.ResultsData from N=4135 participants (Mean SD; Age: 47 12 y; Sex: 83% Female, BMI: 27 6 kg/m2). Median glycaemic variability was 14.8% (IQR 12.6-17.6%), median TIRADA was 95.8% (IQR 89.6-98.6%) and TIR3.9-5.6 was 75.0% (IQR 64.6-82.8%). Greater TIR3.9-5.6 was associated with lower HbA1c, ASCVD 10y risk and HOMA-IR (all p < 0.05). Lower glycaemic variability was associated with lower % energy derived from carbohydrate (rs: 0.17, p < 0.01), ultra-processed foods (NOVA 4, % EI; rs: 0.12, p = 0.01) and a longer overnight fasting duration (rs: -0.10, p = 0.01).ConclusionsA stringent TIR target provides sensitivity to detect changes in HOMA-IR, ASCVD 10 y risk and HbA1c that were not detected using ADA secondary targets. Associations among TIR, glycaemic variability, dietary intake (e.g. carbohydrate and protein) and habits (e.g. nocturnal fasting duration) highlight potential strategic targets to improve glycaemic metrics derived from continuous glucose monitors.

Project description:Hyperglycemia is associated with increased morbidity and mortality in critically ill patients and strict glycemic control has become standard care for adults. Recent studies have questioned the optimal targets for such management and reported increased rates of iatrogenic hypoglycemia in both critically ill children and adults. The ability to provide accurate, real-time continuous glucose monitoring would improve the efficacy and safety of this practice in critically ill patients. The aim of our study is to determine if a continuous, interstitial glucose monitor will correlate with blood glucose values in critically ill children.We evaluated 50 critically ill children age 6 weeks to 16 years old with a commercially available continuous glucose monitor (CGM; Medtronic Guardian®). CGM values and standard blood glucose (BG) values were compared. During the study, no changes in patient management were made based on CGM readings alone.Forty-seven patients had analyzable CGM data. A total of 1,555 CGM and routine BG measurements were compared using Clarke error grid and Bland-Altman analysis. For all readings, 97.9% were within clinically acceptable agreement. The mean absolute relative difference between CGM and BG readings was 15.3%. For the 1,555 paired CGM and BG measurements, there is a statistically significant linear relationship between CGM values and BG (P < .0001). A high degree of clinical agreement existed in three subpopulation analyses based on age, illness severity, and support measures. This included some of our smallest patients (that is, < 12 months old), those who required vasopressors, and those who were treated for critical illness hyperglycemia.In one of the largest studies to date, in a highly vulnerable ICU population, CGM values have a clinically acceptable correlation with the BG values now used diagnostically and therapeutically. Our data contest the theoretical concerns posed by some regarding CGM use in the ICU. The existing medical evidence may now support a role for CGM devices in the identification and management of hyperglycemia in diverse ICU settings.

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Dataset Information

Variation of interstitial glucose measurements assessed by continuous glucose monitors in healthy, nondiabetic individuals.

Objective

Research design and methods

Results

Conclusions

Publications

Variation of interstitial glucose measurements assessed by continuous glucose monitors in healthy, nondiabetic individuals.

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