Glycemic variability diary as a tool for assessing the effectiveness of diabetes therapy. Clear and accessible. Case series
- Authors: Smirnova E.Y.1
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Affiliations:
- City Polyclinic № 44, St. Petersburg
- Issue: Vol 30, No 3 (2023)
- Pages: 128-135
- Section: Clinical case
- URL: https://journals.eco-vector.com/2073-4034/article/view/456433
- DOI: https://doi.org/10.18565/pharmateca.2023.3.128-135
- ID: 456433
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Abstract
Background. Modern approaches to the therapy of diabetes mellitus (DM) involve the assessment of the success of therapy and glycemic control by the glycated hemoglobin level. Recently, however, the assessment of glycemic variability (GV) has become of great importance. Previously, assessment of GV required continuous monitoring of glycemia. Currently, such a tool as a of glycemic variability diary (GVD) is available.
Description of case series. Five clinical cases of patients with decompensated DM2 are presented. All patients underwent an assessment of glycemic control according to GVD before and after changing therapy. GVD that makes it possible to assess the efficacy and safety of DM therapy, and glycemic variability is used as an independent risk factor for the development of severe hypoglycemic conditions, diabetic micro- and macroangiopathy [1].
Conclusion. GVD has proven to be effective and important in the outpatient setting. The improvement of carbohydrate metabolism compensation when switching to ultra-long-acting insulin degludec with an increase in the time spent in the target glycemic range, a decrease in glycemic variability has been clearly demonstrated.
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About the authors
Ekaterina Yu. Smirnova
City Polyclinic № 44, St. Petersburg
Author for correspondence.
Email: katrin_cat@list.ru
ORCID iD: 0000-0003-2487-0038
Endocrinologist, City Polyclinic № 44, St. Petersburg, Russia
Russian Federation, St. PetersburgReferences
- Анциферов М.Б., Демидов Н.А., Котешкова О.М. и др. Оценка вариабельности уровня гликемии на основе самоконтроля. Результаты пилотного проекта. Эндокринология: новости, мнения, обучение. 2021;10(2):26–31. [Antsiferov M.B., Demidov N.A., Koteshkova O.M. Evaluation of the variability of the level of glycemia based on self-control. Pilot project results. Endokrinologiya: novosti, mneniya, obuchenie. 2021;10(2):26–31. (In Russ.)]. doi: 10.33029/2304-9529-2021-10-2-26-31.
- UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–53. doi: 10.1016/S0140-6736(98)07019-6.
- Battelino T., Danne T., Bergenstal R.M., et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diab Care. 2019;42(8):1593–603. doi: 10.2337/dci19-0028.
- Hashimoto K., Osugi T., Noguchi S., et al. A1C but not serum glycated albumin is elevated because of iron deficiency in late pregnancy in diabetic women. Diab Care. 2010;33(3):509–11. doi: 10.2337/dc09-1954.
- Inaba M., Okuno S., Kumeda Y., et al. Osaka CKD Expert Research Group. Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. J Am Soc Nephrol. 2007;18(3):896–903. Doi: 10.1681/ ASN.2006070772.
- Bry L., Chen P.C., Sacks D.B. Effects of Hemoglobin Variants and Chemically Modified Derivatives on Assays for Glycohemoglobin. Clin Chem. 2001;47(2):153–63. doi: 10.1093/clinchem/47.2.153.
- Ford E.S., Cowie C.C., Li C., et al. Iron-deficiency anemia, non-iron-deficiency anemia and HbA1c among adults in the US. J Diab. 2011;3(1):67–73. doi: 10.1111/j.1753-0407.2010.00100.x.
- Клинические рекомендации Сахарный диабет 2 типа у взрослых, МЗ РФ, 2022.
- Davies M.J., et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022;65(12):1925–66. doi: 10.1007/s00125- 022-05787-2.
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