Abstract
Objective To investigate the effects of Flash Glucose Monitoring (FGM) on
glucose profile in people with Type 2 Diabetes Mellitus (T2DM) receiving
anti-diabetic drug medication.
Methods This is a prospective non-randomized uncontrolled study. 111
people with T2DM were enrolled and received FGM for 14 days. There was no change
of anti-diabetic medication during the 14 days. The plasma glucose concentration
on day 2 was used as baseline and the day 13 was considered as study end point.
The parameters to compare were mean plasma glucose (MPG), glucose variations,
and incidence of hypoglycemia during the FGM period. The multivariate linear
stepwise regression analysis was applied to determine the independent factors
that affect MPG difference.
Results This study analyzed the data of a total of 111 people with T2DM
(male 60 and female 51). The general clinical data of these patients were as
follows: age: 65.0±6.7 years old; duration of diabetes: 11.6±6.8
years; HbA1c: 61.2±13.3 mmol/mol; body mass index (BMI):
25.2±3.2 kg/m². Using FGM, people with T2DM were
able to change daily diet and exercise through which significant reductions in
MPG on days 12 or 13 were achieved as compared with that of day 2
(P=0.04 or P=0.003, respectively). The glucose variations, such
as standard deviation (SD) of plasma glucose, coefficient of variation (CV), and
mean amplitude of glycemic excursion (MAGE), progressively declined starting
from day 6 as compared with baseline (P=0.016, P=0.003, or
P=0.012, respectively). The incremental area over the curve (AOC) of the
hypoglycemia (<3.9 mmol/L) had a significant reduction
starting from the day 3 (P=0.001). When people with T2DM were divided
into 3 groups based on the tertile of HbA1c (high, middle, and low
concentrations), the reduction of MPG in patients with high concentration of
HbA1c were much larger than that in middle and low concentration group patients
(P=0.001 for both). The incidence of hypoglycemia was improved in the
low concentration group (P=0.017). The optimal frequency of scanning
time required to maintain euglycemia was 11.7 times/day as calculated by
the receiver operating characteristic (ROC) analysis.
Conclusion Using FGM to monitor glucose concentration at 11.7
times/day, people with T2DM can achieve a better glucose control in
addition to anti-diabetic drug medication through changing daily diet and
exercise, especially in patients with high concentration of HbA1c
(>66.1 mmol/mol).
Key words
flash glucose monitoring - HbA1c - type 2 diabetes mellitus - self-glycemic management
