PMID- 30934620
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2076-3271 (Electronic)
IS  - 2076-3271 (Linking)
VI  - 7
IP  - 3
DP  - 2019 Mar 25
TI  - Patterns of Glycemic Variability During a Diabetes Self-Management Educational 
      Program.
LID - 10.3390/medsci7030052 [doi]
LID - 52
AB  - BACKGROUND: Variations in blood glucose levels over a given time interval is 
      termed as glycemic variability (GV). Higher GV is associated with higher 
      diabetes-related complications. The current study was done with the aim of 
      detecting the sensitivity of various GV indices among individuals with type 2 
      diabetes mellitus of different glycemic control status. METHODS: We performed a 
      longitudinal study among individuals with type 2 diabetes mellitus (T2DM) who 
      were participating in a two-week diabetes self-management education (DSME) 
      program. Participants were categorized by their HbA1c as poor (>/=8%), acceptable 
      (7%(-)8%), and optimal control (<7%). Continuous glucose monitoring (CGM) sensors 
      recorded interstitial glucose every 15 min from day 1. The evaluated GV measures 
      include standard deviation (SD), coefficient of variation (CV), mean amplitude of 
      glycemic excursion (MAGE), continuous overlapping net glycemic action (CONGA), 
      mean of daily difference for inter-day variation (MODD), high blood glucose index 
      (HBGI), and low blood glucose index (LBGI). RESULTS: A total of 41 study 
      participants with 46347 CGM values were available for analysis. Of 41 
      participants, 20 (48.7%) were in the poor, 10 (24.3%) in the acceptable, and 11 
      (26.8%) in the optimal control group. The GV indices (SD; CV; MODD; MAGE; CONGA; 
      HBGI) of poorly controlled (77.43; 38.02; 45.82; 216.63; 14.10; 16.62) were 
      higher than acceptable (50.02; 39.32; 30.79; 138.01; 8.87; 5.56) and optimal 
      (34.15; 29.46; 24.56; 126.15; 8.67; 3.13) control group. Glycemic variability was 
      reduced in the poorly and acceptably controlled groups by the end of the 2-week 
      period. There was a rise in LBGI in the optimally controlled group, indicating 
      pitfalls of tight glycemic control. CONCLUSION: Indices of glycemic variability 
      are useful complements, and changes in it can be demonstrated within short 
      periods.
FAU - Joshi, Ankur
AU  - Joshi A
AD  - Department of Community and Family Medicine, All India Institute of Medical 
      Sciences (AIIMS), Bhopal 462020 India. ankur.cfm@aiimsbhopal.edu.in.
FAU - Mitra, Arun
AU  - Mitra A
AUID- ORCID: 0000-0001-6742-4033
AD  - Department of Community and Family Medicine, All India Institute of Medical 
      Sciences (AIIMS), Bhopal 462020 India. dr.arunmitra@gmail.com.
FAU - Anjum, Nikhat
AU  - Anjum N
AD  - Hospital Services, All India Institute of Medical Sciences, Bhopal 462020, India. 
      nutritionistnikhat@gmail.com.
FAU - Shrivastava, Neelesh
AU  - Shrivastava N
AD  - Department of Medicine, All India Institute of Medical Sciences, Bhopal 462020, 
      India. neeleshstv@gmail.com.
FAU - Khadanga, Sagar
AU  - Khadanga S
AD  - Department of Medicine, All India Institute of Medical Sciences, Bhopal 462020, 
      India. sagar.genmed@aiimsbhopal.edu.in.
FAU - Pakhare, Abhijit
AU  - Pakhare A
AUID- ORCID: 0000-0003-2897-4141
AD  - Department of Community and Family Medicine, All India Institute of Medical 
      Sciences (AIIMS), Bhopal 462020 India. abhijit.cfm@aiimsbhopal.edu.in.
FAU - Joshi, Rajnish
AU  - Joshi R
AUID- ORCID: 0000-0002-4702-0522
AD  - Department of Medicine, All India Institute of Medical Sciences, Bhopal 462020, 
      India. rajnish.genmed@aiimsbhopal.edu.in.
LA  - eng
PT  - Journal Article
DEP - 20190325
PL  - Switzerland
TA  - Med Sci (Basel)
JT  - Medical sciences (Basel, Switzerland)
JID - 101629322
PMC - PMC6473237
OTO - NOTNLM
OT  - CONGA
OT  - HBGI
OT  - LBGI
OT  - MAGE
OT  - MODD
OT  - glycemic variability
COIS- The authors declare no conflict of interest. The CGMS sensor manufacturer had no 
      role in the design and conduct of study.
EDAT- 2019/04/03 06:00
MHDA- 2019/04/03 06:01
PMCR- 2019/03/25
CRDT- 2019/04/03 06:00
PHST- 2019/01/24 00:00 [received]
PHST- 2019/03/14 00:00 [revised]
PHST- 2019/03/19 00:00 [accepted]
PHST- 2019/04/03 06:00 [entrez]
PHST- 2019/04/03 06:00 [pubmed]
PHST- 2019/04/03 06:01 [medline]
PHST- 2019/03/25 00:00 [pmc-release]
AID - medsci7030052 [pii]
AID - medsci-07-00052 [pii]
AID - 10.3390/medsci7030052 [doi]
PST - epublish
SO  - Med Sci (Basel). 2019 Mar 25;7(3):52. doi: 10.3390/medsci7030052.