Variability Of Glucose And Lifestyle In Continuous Glucose Monitoring (CGM)
Hiroshi BANDO*, Yoshikane KATO, Setsuko KANAZAWA, Mayumi TANAKA, Etsuko SUEKI, Hiroe KANAGAWA, Takafumi KAWATA, Atsuko KAWAHITO
Address: Hiroshi BANDO, MD, PhD, FACP, Tokushima University / Medical Research, Nakashowa 1-61, Tokushima 770-0943, Japan.
Background: Investigation of glucose variability is crucial for patient with Type 1 Diabetes mellitus (T1DM) on insulin treatment. For Continuous Glucose Monitoring (CGM), FreeStyle Libre (Abbott) has been introduced to clinical practice with useful and beneficial efficacy.
Case and Results: The patient was 55 year-old T1DM female with body mass index (BMI) 21 kg/m2, HbA1c 8.0 %. She was on CGM for 14 days, with obtained glucose data in every 15 minutes. Treatment included multiple daily insulin injection (MDI) of Insulin Aspart 3 times and Insulin Glargin once a day. She showed unstable blood glucose variability with hyperglycemia and hypoglycemia, besides 2 hours delay shift in daily lifestyle rhythm. There was a discrepancy of HbA1c between actual value 8.0% and presumed value 6.9% by FreeStyle Libre.
Discussion and Conclusion: Obtained glucose data from FreeStyle Libre have been satisfactory. One reason for lower HbA1c value would be from the characteristic tendency in lower glucose region. Larger distribution of glucose variability would be due to delayed shift of lifestyle, sleep situation and irregular meal. These results would become the basal data for CGM, the reference to better modification of MDI and clinical diabetic practice in future research.