Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose

Hypoglycemia detection in T2DM patients is an important issue which is usually accomplished with self-monitoring of blood glucose (SMBG). Optimal schedule of testing and diagnostic threshold are important for effective SMBG. Aims of study: To evaluate hypoglycemia frequency by SMBG using structured...

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Main Authors: A. V. Petrov, L. G. Strongin
Format: Article
Language:Russian
Published: Remedium Group LLC 2018-07-01
Series:Медицинский совет
Subjects:
Online Access:https://www.med-sovet.pro/jour/article/view/2573
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author A. V. Petrov
L. G. Strongin
author_facet A. V. Petrov
L. G. Strongin
author_sort A. V. Petrov
collection DOAJ
description Hypoglycemia detection in T2DM patients is an important issue which is usually accomplished with self-monitoring of blood glucose (SMBG). Optimal schedule of testing and diagnostic threshold are important for effective SMBG. Aims of study: To evaluate hypoglycemia frequency by SMBG using structured AccuChek 360 View protocol and glucose monitoring and increase SMBG efficacy in the detection of hypoglycemia. Study design: 16 T2DM patients after initiation of insulin treatment were included. Each patient had 3 days of glucose monitoring together with SMBG 7 times a day after hospital discharge and 3 months later. Results: Hypoglycemia was detected in 38% of monitoring periods; this patients had higher glucose variability and lower average glucose. SMBG detected hypoglycemia in 16% of periods. 6 out of 7 unrecognized hypoglycemias were during night. This 6 cases were characterized by minimal daytime glucose levels by SMBG below 5 mmol/l. ROC-analysis demonstrated minimal glucose level during daytime of 4.8 mmol/l to have 92% sensitivity and 74% specificity for detection of any hypoglycemia by glucose monitoring. Conclusion: Structured Accu-Chek 360 View SMBG can reliably detect daytime hypoglycemia but regular nighttime testing is recommended in all T2DM patients using insulin for detection of nighttime hypoglycemia. Minimal glucose levels below 4.8-5 mmol/l during daytime corresponds with high hypoglycemia risk.
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spelling doaj.art-82acef1ccbe74e9c95f9a23ec40cee142023-04-23T06:57:06ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902018-07-0101211211610.21518/2079-701X-2018-12-112-1162533Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucoseA. V. Petrov0L. G. Strongin1Privolzhskiy Research Medical University of the Ministry of Russia, Nizhny NovgorodPrivolzhskiy Research Medical University of the Ministry of Russia, Nizhny NovgorodHypoglycemia detection in T2DM patients is an important issue which is usually accomplished with self-monitoring of blood glucose (SMBG). Optimal schedule of testing and diagnostic threshold are important for effective SMBG. Aims of study: To evaluate hypoglycemia frequency by SMBG using structured AccuChek 360 View protocol and glucose monitoring and increase SMBG efficacy in the detection of hypoglycemia. Study design: 16 T2DM patients after initiation of insulin treatment were included. Each patient had 3 days of glucose monitoring together with SMBG 7 times a day after hospital discharge and 3 months later. Results: Hypoglycemia was detected in 38% of monitoring periods; this patients had higher glucose variability and lower average glucose. SMBG detected hypoglycemia in 16% of periods. 6 out of 7 unrecognized hypoglycemias were during night. This 6 cases were characterized by minimal daytime glucose levels by SMBG below 5 mmol/l. ROC-analysis demonstrated minimal glucose level during daytime of 4.8 mmol/l to have 92% sensitivity and 74% specificity for detection of any hypoglycemia by glucose monitoring. Conclusion: Structured Accu-Chek 360 View SMBG can reliably detect daytime hypoglycemia but regular nighttime testing is recommended in all T2DM patients using insulin for detection of nighttime hypoglycemia. Minimal glucose levels below 4.8-5 mmol/l during daytime corresponds with high hypoglycemia risk.https://www.med-sovet.pro/jour/article/view/2573t2dminsulinsmbgcgmshypoglycemia
spellingShingle A. V. Petrov
L. G. Strongin
Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose
Медицинский совет
t2dm
insulin
smbg
cgms
hypoglycemia
title Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose
title_full Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose
title_fullStr Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose
title_full_unstemmed Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose
title_short Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose
title_sort hypoglycemia after initiating insulin therapy based on the results of structured self control and monitoring of blood glucose
topic t2dm
insulin
smbg
cgms
hypoglycemia
url https://www.med-sovet.pro/jour/article/view/2573
work_keys_str_mv AT avpetrov hypoglycemiaafterinitiatinginsulintherapybasedontheresultsofstructuredselfcontrolandmonitoringofbloodglucose
AT lgstrongin hypoglycemiaafterinitiatinginsulintherapybasedontheresultsofstructuredselfcontrolandmonitoringofbloodglucose