Saboo Banshi, Sheth Shruti V, Joshi Shashank, Bhandari Sudhir, Kesavadev Jothydev, Maheshwari Anuj, Agrawal Manish, Hasnani Dhruvi, Patel Feny, Panchal Dharmendra, Goklani Rutul
Diacare - Diabetes Care and Hormone Clinic, Ahmedabad, Gujarat, India.
Consultant Endocrinologist, Lilavati Hospital and Research Centre.
J Assoc Physicians India. 2018 Jul;66(7):69-71.
To demonstrate glycemic variability in type 2 diabetic patients and consequent control of the same.
108 patients with type 2 diabetes with an HbA1c level of 7.5-8.5% were selected for the study. A Freestyle Libre Pro AGP sensor was applied to the patients after explaining the patient about the same. Next, they were called for follow up at 3rd, 7th, 11th and 14th days. Based on the readings and graph obtained, diet and treatment changes were made on various follow-up days. The sensor was removed at the end of 14 days.
Out of the 108 subjects, 106 completed the study. There were no adverse device effects. 98 patients had therapy changes while the rest had diet and lifestyle modifications. The mean HbA1c decreased from 7.96% to 7.03% by the end of 15 days. The glycemic variability curves helped in recognizing and treating masked or asymptomatic hypoglycemic events. It also graphically shows intervals of optimal and sub-optimal glycemia.
AGP is one of the most recent, innovative developments that are being used to monitor Glycaemic variability in DM patients. AGP is generated from the Flash Glucose Monitoring device which is like a CGM device attached to the patient for a maximum period of 14 days, which checks the ISF glucose at every 15 minutes. We are able to get a Glycaemic variability curve, a median, a modal, various percentiles and statistical data generated through this. AGP study in the patient provides the doctor with an opportunity to have a complete glycemic picture of the patient l. It offers a reliable, predictive, standardized visualization of the glucose data. We were able to not only reduce the Glycaemic variability but were also able to improve their Quality of Life by reducing the frequency of hypos. The data lead to breaking of the clinical inertia and provided a valuable insight into Glycaemic patterns. The achievement of near to normal Glycaemic status at the end of 14 days reflected the use of AGP as an interventional tool.
展示2型糖尿病患者的血糖变异性及其相应控制情况。
选择108例糖化血红蛋白（HbA1c）水平在7.5 - 8.5%的2型糖尿病患者进行研究。在向患者解释后，为其应用Freestyle Libre Pro AGP传感器。接下来，在第3天、第7天、第11天和第14天对他们进行随访。根据获得的读数和图表，在不同随访日进行饮食和治疗调整。14天结束时移除传感器。
108名受试者中，106名完成了研究。未出现不良设备效应。98名患者进行了治疗调整，其余患者进行了饮食和生活方式改变。到第15天结束时，平均HbA1c从7.96%降至7.03%。血糖变异性曲线有助于识别和治疗隐匿性或无症状性低血糖事件。它还以图形方式显示最佳和次最佳血糖区间。
AGP是用于监测糖尿病患者血糖变异性的最新创新性进展之一。AGP由闪光葡萄糖监测设备生成，该设备类似于连续血糖监测（CGM）设备，最多可附着在患者身上14天，每15分钟检查一次间质液葡萄糖。我们能够通过此获得血糖变异性曲线、中位数、众数、各种百分位数以及统计数据。对患者进行AGP研究为医生提供了全面了解患者血糖情况的机会。它提供了可靠、可预测、标准化的葡萄糖数据可视化。我们不仅能够降低血糖变异性，还能够通过减少低血糖发生频率来改善他们的生活质量。这些数据打破了临床惰性，并为血糖模式提供了有价值的见解。14天结束时接近正常血糖状态的实现反映了AGP作为一种干预工具的应用。
