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Erschienen in: Endocrine 2/2022

21.06.2022 | Brief report

Continuous glucose monitoring and 1-h plasma glucose identifies glycemic variability and dysglycemia in high-risk individuals with HbA1c < 5.7%: a pilot study

verfasst von: Brenda Dorcely, Eliud Sifonte, Collin Popp, Anjana Divakaran, Karin Katz, Sarah Musleh, Ram Jagannathan, Margaret Curran, Mary Ann Sevick, José O. Aleman, Ira J. Goldberg, Michael Bergman

Erschienen in: Endocrine | Ausgabe 2/2022

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Excerpt

The global incidence and prevalence of diabetes continue to rise [1]. Hence, identifying individuals at high risk for prediabetes and type 2 diabetes (T2D) is paramount. As glucose levels increase insidiously in the progression from normal glucose tolerance to prediabetes and T2D, early identification of high-risk individuals could result in the prescription of lifestyle interventions to decrease progression to T2D. HbA1c is widely used to screen for prediabetes (5.7–6.4% [39–46 mmol/mol]) and T2D (≥6.5% [48 mmol/mol]) [2]. However, HbA1c has poor sensitivity in identifying early pancreatic β-cell dysfunction [3]. Individuals with prediabetes, already on the accelerated slope of the glucose trajectory, are diagnosed too late in the progression to T2D when significant β-cell dysfunction has already occurred. Increased 1-hour plasma glucose (1-h PG) ≥ 155 mg/dL (8.6 mmol/L) during a 75-g oral glucose tolerance test (OGTT) is more predictive than HbA1c or 2-h PG for future development of diabetes, complications, and mortality [46]. However, measurement of the 1-h PG during the OGTT requires fasting. In addition, plasma glucose (PG) levels can become unstable if specimens are not properly handled [7]. A potential alternative approach for detecting early pancreatic β-cell dysfunction is implementation of continuous glucose monitoring (CGM) during an OGTT. CGM can identify increased glycemic variability (GV), an index of glucose fluctuation, in patients with T2D [8]. However, it is unclear if CGM can detect GV in high-risk subjects without diabetes or with HbA1c < 5.7% (39 mmol/mol). …
Literatur
2.
Zurück zum Zitat American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care 45(Suppl 1), S17–S38 (2022). https://doi.org/10.2337/dc22-S002 American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care 45(Suppl 1), S17–S38 (2022). https://​doi.​org/​10.​2337/​dc22-S002
4.
Zurück zum Zitat L. Cao, P. Wang, H. Luan et al. Elevated 1-h postload plasma glucose levels identify coronary heart disease patients with greater severity of coronary artery lesions and higher risk of 1-year re-admission. Diab. Vasc. Dis. Res. 17(1), 1479164119896978 (2020). https://doi.org/10.1177/1479164119896978 L. Cao, P. Wang, H. Luan et al. Elevated 1-h postload plasma glucose levels identify coronary heart disease patients with greater severity of coronary artery lesions and higher risk of 1-year re-admission. Diab. Vasc. Dis. Res. 17(1), 1479164119896978 (2020). https://​doi.​org/​10.​1177/​1479164119896978​
Metadaten
Titel
Continuous glucose monitoring and 1-h plasma glucose identifies glycemic variability and dysglycemia in high-risk individuals with HbA1c < 5.7%: a pilot study
verfasst von
Brenda Dorcely
Eliud Sifonte
Collin Popp
Anjana Divakaran
Karin Katz
Sarah Musleh
Ram Jagannathan
Margaret Curran
Mary Ann Sevick
José O. Aleman
Ira J. Goldberg
Michael Bergman
Publikationsdatum
21.06.2022
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 2/2022
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-022-03109-5

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