Assessment of the variability of glycemic levels based on self-control. Pilot project results
AbstractModern approaches to the treatment of type 1 diabetes mellitus (DM) involve assessing the quality of glycemic control by the Level of glycated hemoglobin (HbA1c). However, in recent years, it has become important to assess the variability of glycemia (GV) as an independent risk factor for the development of severe hypoglycemia, diabetic micro- and macroangiopathy. As a rule, continuous glycemic monitoring (CGM) is required to assess GV. Of interest is the possibility of assessing GV using structured self-monitoring of blood glucose (SMBG) with subsequent statistical processing of the data obtained.
Aim - to study the possibility of using SMBG for assessing GV in comparison with CGM.
Material and methods. Patients were examined using CGM for 14 days with simultaneous SMBG. Statistical analysis of the data obtained has been carried out.
Results. 25 patients with DM1: 7 (28.0%) male and 18 (72.0%) women were examined. Patient age - 41.0 ±12.8 years, disease duration 18.7±12.7 years, body mass index - 26.4±4.7 kg/m2, HbA1c - 7.9±1.8%. A strong direct correlation between the coefficients of variation (CV) obtained from the SMBG and CGM data was revealed (r=0.965, p<0.001).
Conclusion. There is a strong direct correlation between the CV obtained from the CGM and SMBG data (r=0.947, p<0.001). The CV obtained during the SMBG in 96% of cases exceeds the CV obtained from the CGM results. In 88% of patients, GV indices obtained with CGM and SMBG did not differ statistically significantly (p>0.05). With a CV for SMBG >40%, the likelihood of CV >36,0% for CGM is greater than 95%.
Keywords:continuous glucose monitoring, glycemic variability, glycemic variability diary
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Antsiferov M.B., Demidov N.A., Koteshkova O.M., Markova T.N., Pashkova E.Yu., Mishra O.A., Kurganovich A.V. Assessment of the variability of glycemic levels based on self-control. Pilot project results. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2021; 10 (2): 26-31. DOI: https://doi.org/10.33029/2304-9529-2021-10-2-26-31 (in Russian)
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