1.
Flash Glucose Monitoring Improves Glucose Control in People with Type 2 Diabetes Mellitus Receiving Anti-diabetic Drug Medication.
Chen, M, Li, H, Shen, Y, Liu, B, Yan, R, Sun, X, Ye, L, Lee, KO, Ma, J, Su, X
Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. 2021;(12):857-863
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).
2.
Comparative effectiveness of sodium-glucose co-transporter 2 inhibitors for controlling hyperglycaemia in patients with type 2 diabetes: protocol for a systematic review and network meta-analysis.
Chen, M, Xie, CG, Gao, H, Zheng, H, Chen, Q, Fang, JQ
BMJ open. 2016;(1):e010252
Abstract
INTRODUCTION As a new class of glucose-lowering drugs, sodium-glucose co-transporter 2 (SGLT2) inhibitors are effective for controlling hyperglycaemia, however, the relative effectiveness and safety of 6 recently available SGLT2 inhibitors have rarely been studied. Therefore, we aim to perform pairwise comparisons of the 6 SGLT2 inhibitors. METHODS AND ANALYSIS A systematic review and network meta-analysis will be conducted. Clinical studies that examine effectiveness and safety of either canagliflozin, dapagliflozin, empagliflozin, ipragliflozin, tofogliflozin or luseogliflozin will be included. These studies will be systematically retrieved in MEDLINE, EMBASE and the Cochrane Library, from inception to November 2015. Two reviewers will independently screen for eligible studies and then extract data from the studies as well as assess risk of bias. Discrepancies in screening and data extraction will be arbitrated by a third reviewer. A traditional meta-analysis will be performed to combine the effect sizes calculated from head-to-head comparisons with a random effect model. The effect sizes computed from indirect comparisons will be further combined in a network meta-analysis. Heterogeneity will be tested with the Cochrane's Q statistic, and publication bias will be assessed using a funnel plot and the Egger's test. ETHICS AND DISSEMINATION Relative effectiveness and harms of the 6 SGLT2 inhibitors will be demonstrated through this systematic review and network meta-analysis. The result of the review will be disseminated through a peer-review journal and conference presentations. Patients, clinicians and policymakers will benefit from this review in selecting a SGLT2 inhibitor for glucose control in patients with type 2 diabetes. TRIAL REGISTRATION NUMBER PROSPERO CRD42015025981.
3.
Welltang - A smart phone-based diabetes management application - Improves blood glucose control in Chinese people with diabetes.
Zhou, W, Chen, M, Yuan, J, Sun, Y
Diabetes research and clinical practice. 2016;:105-10
Abstract
AIMS: The primary objective was to evaluate the impact of the smart phone-based diabetes management application, Welltang, on glycated hemoglobin (HbA1c). The second objective was to measure whether Welltang improves blood glucose, low-density lipoprotein cholesterol, weight, blood pressure, hypoglycemic events, satisfaction of patients to use Welltang, diabetes knowledge of patients, and self-care behaviors. METHODS One hundred evenly randomized subjects with diabetes, aged 18-74years, were recruited from the outpatient Department of Endocrinology for a 3-month study. The Welltang intervention group received training for the use of Welltang, while the control group received their usual standard of care. HbA1c, blood glucose, low-density lipoprotein cholesterol, weight, blood pressure, hypoglycemic events, satisfaction of patients to use Welltang, diabetes knowledge of patients, and self-care behaviors were measured. Patient data were analyzed using independent t test and paired sample test using SPSS version 12. RESULTS The average decrease in HbA1c was 1.95% (21mmol/mol) in the intervention group and 0.79% (8mmol/mol) in the control group (P<0.001). Measures of self-monitored blood glucose, diabetes knowledge, and self-care behaviors improved in patients in the intervention group. Eighty four percent of patients in the intervention group were satisfied with the use of Welltang. Differences in hypoglycemic events, low-density lipoprotein cholesterol, weight, and blood pressure were not statistically significant. CONCLUSION Diabetes patients using the Welltang application achieved statistically significant improvements in HbA1c, blood glucose, satisfaction of patients to use of Welltang, diabetes knowledge, and self-care behaviors.