Glycemic Control and Variability of Diabetes Secondary to Total Pancreatectomy Assessed by Continuous Glucose Monitoring
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Glycemic Control and Variability of Diabetes Secondary to Total Pancreatectomy Assessed by Continuous Glucose Monitoring. / Juel, Caroline T.B.; Dejgaard, Thomas F.; Hansen, Carsten P.; Storkholm, Jan H.; Vilsbøll, Tina; Lund, Asger; Knop, Filip K.
I: The Journal of clinical endocrinology and metabolism, Bind 106, Nr. 1, 2021, s. 168-173.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Glycemic Control and Variability of Diabetes Secondary to Total Pancreatectomy Assessed by Continuous Glucose Monitoring
AU - Juel, Caroline T.B.
AU - Dejgaard, Thomas F.
AU - Hansen, Carsten P.
AU - Storkholm, Jan H.
AU - Vilsbøll, Tina
AU - Lund, Asger
AU - Knop, Filip K.
N1 - A correction has been published: The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 7, July 2021, Page e2854, https://doi.org/10.1210/clinem/dgab285
PY - 2021
Y1 - 2021
N2 - CONTEXT: The extent of the glycemic variability in diabetes secondary to total pancreatectomy is not fully understood. OBJECTIVE: To evaluate glycemic variability in totally pancreatectomized (PX) patients and compare it to glycemic variability in hemoglobin A1c (HbA1c)-matched patients with long-standing type 1 diabetes (T1D). DESIGN: A case-control study was performed. SETTING: Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. PATIENTS OR OTHER PARTICIPANTS: Ten PX patients (mean [SEM]: age 64.3 [9.8] years; body mass index (BMI) 34.4 [5.0] kg/m2; duration of diabetes 3 [2.8] years), 10 HbA1c-matched patients with T1D (63.9 [8.6] years; 24.6 [3.1] kg/m2; 22 [4] years), and 10 gender-, age-, and BMI-matched healthy controls. All patients were managed on multiple daily injections of insulin. INTERVENTION: Continuous glucose monitoring (CGM) (Medtronic MiniMed iPro 2) during 12 consecutive days. MAIN OUTCOME MEASURES: Glycemic variability. RESULTS: HbA1c levels were similar in the PX group and the T1D group. The PX group had greater continuous overall net glycemic action per 60 minutes (CONGA60 min) compared with the T1D group (mean [SEM]: 9.5 [0.3] vs 8.3 [0.2] mmol/L, P < 0.003) and mean plasma glucose values were higher in the PX group (10.6 [0.9] vs 9.0 [0.9] mmol/L, P < 0.001), whereas coefficient of variation for plasma glucose and standard deviation of mean plasma glucose, respectively, were similar in the 2 groups. Time spent below range was not different between the PX and the T1D group (2.3 [0.8] vs 4.5 [0.8]%, P = 0.065), whereas time spent above range was higher in the PX group (51.4 [3.3] vs 37.6 [1.9]%, P < 0.001). CONCLUSIONS: CGM-assessed glycemic variability showed higher CONGA60 min and time spent above range in our PX patients compared with HbA1c-matched T1D patients. This study is registered at www.ClinicalTrials.gov (NCT02944110).
AB - CONTEXT: The extent of the glycemic variability in diabetes secondary to total pancreatectomy is not fully understood. OBJECTIVE: To evaluate glycemic variability in totally pancreatectomized (PX) patients and compare it to glycemic variability in hemoglobin A1c (HbA1c)-matched patients with long-standing type 1 diabetes (T1D). DESIGN: A case-control study was performed. SETTING: Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. PATIENTS OR OTHER PARTICIPANTS: Ten PX patients (mean [SEM]: age 64.3 [9.8] years; body mass index (BMI) 34.4 [5.0] kg/m2; duration of diabetes 3 [2.8] years), 10 HbA1c-matched patients with T1D (63.9 [8.6] years; 24.6 [3.1] kg/m2; 22 [4] years), and 10 gender-, age-, and BMI-matched healthy controls. All patients were managed on multiple daily injections of insulin. INTERVENTION: Continuous glucose monitoring (CGM) (Medtronic MiniMed iPro 2) during 12 consecutive days. MAIN OUTCOME MEASURES: Glycemic variability. RESULTS: HbA1c levels were similar in the PX group and the T1D group. The PX group had greater continuous overall net glycemic action per 60 minutes (CONGA60 min) compared with the T1D group (mean [SEM]: 9.5 [0.3] vs 8.3 [0.2] mmol/L, P < 0.003) and mean plasma glucose values were higher in the PX group (10.6 [0.9] vs 9.0 [0.9] mmol/L, P < 0.001), whereas coefficient of variation for plasma glucose and standard deviation of mean plasma glucose, respectively, were similar in the 2 groups. Time spent below range was not different between the PX and the T1D group (2.3 [0.8] vs 4.5 [0.8]%, P = 0.065), whereas time spent above range was higher in the PX group (51.4 [3.3] vs 37.6 [1.9]%, P < 0.001). CONCLUSIONS: CGM-assessed glycemic variability showed higher CONGA60 min and time spent above range in our PX patients compared with HbA1c-matched T1D patients. This study is registered at www.ClinicalTrials.gov (NCT02944110).
KW - continuous glucose monitoring
KW - glycemic variability
KW - secondary diabetes
KW - total pancreatectomy
U2 - 10.1210/clinem/dgaa731
DO - 10.1210/clinem/dgaa731
M3 - Journal article
C2 - 33053154
AN - SCOPUS:85099072611
VL - 106
SP - 168
EP - 173
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 1
ER -
ID: 255354572