The role and place of continuous glucose monitoring in multivariate control of type 2 diabetes
AbstractObjective: To assess the role and place of the continuous glucose monitoring in the management of type 2 diabetes mellitus(T2DM).
Materials and Methods: The study enrolled two groups of patients with T2DM on therapy with oral antidiabetic drugs. 1st group included 60 patients with HbA1c> 7,5%. HbA1c level 40 patients in 2 group was7,0–7,5%. After performing continuous glucose monitoring, depending on the standard deviation of glucose (STDev), each group of patients was divided into two subgroups: A-STDev 2 mmol/l and B-STDev <2 mmol/l. At initially and after 24 weeks each subgroup were evaluated by two parameters: microalbuminuria (MAU) and diabetic polyneuropathy (DPN).
Results: After 24 weeks in a subgroup 1A increase of patients with microalbuminuria was 10.5%. In subgroup 1B not marked upward trend. In the subgroup 1A the number of patients with N1 stage increased by 8,9%, to 7% of cases progressed to the stage of the state of N2. In 1B subgroup N1 step increased by 5%. A 2% increase in the number of patients with stage N2. The increase in group 2A MAU was 11%. MAU. In subgroup 2B not marked upward trend. In the subgroup 2A increase in the number of patients with stage N1 DPN was 9%, with N2 stag-4%. Statistically significant progression of DPN in this subgroup was identified.
Conclusions: The data suggest that glycemic variability may be an independent predictor of late complications of T2DM. Thus, assessment of glycemic variability and quality of glycemic control with the use of continuous glucose monitoring is breaking new ground for a successful and effective management of T2DM.
Keywords:type 2 diabetes mellitus, continuouse Glucose Monitoring System, glycemic control, microalbuminuria, diabetic neuropathy