Comparison of CGM-Derived Measures of Glycaemic Variability Between Pancreatogenic Diabetes and Type 2 Diabetes Mellitus
Fibrocalculous pancreatic diabetes (FCPD) is a form of secondary diabetes that is observed in patients with lean phenotype, insulin dependent, ketosis resistant diabetes with brittle glycaemic control. An inadequate glycaemic control could result in glycaemic variability and increase the risk of hypoglycaemia. Even though HbA1c portrays a better measure of glucose levels, it does not provide appropriate data on Glycaemic Variability (GV). Self-Monitoring of Blood Glucose confers timely measures of blood glucose levels but fails to deliver any data with respect to variations in blood glucose levels. The research titled “Comparison of CGM-Derived Measures of Glycaemic Variability Between Pancreatogenic Diabetes and Type 2 Diabetes Mellitus” was conducted by Channabasappa Shivaprasad and colleagues and the summary of the article has been given below.
Objective:
The research aimed to evaluate GV and incidence of hypoglycaemia in patients having FCPD with the use of CGM and compare them with those in patients with Type 2 Diabetes Mellitus (T2DM).
Method:
GV was measured by using CGM in a sample size of 61 patients diagnosed with FCPD and T2DM. A software called GlyCulator2 was used to analyze the CGM-derived of GV (SD, mean amplitude of glycaemic excursion [MAGE], continuous overall net glycaemic action [CONGA], absolute means of daily differences [MODD], M value, and coefficient of variance [%CV]), hypoglycaemia (TSB < 70 / AUC < 70) and Low Blood Glucose Index (LBGI) and hyperglycaemia (TSA > 180 / AUC > 180), High Blood Glucose Index (HBGI), and J index.
Findings:
Patients with FCPD reported higher GV than those with T2D. This outcome helps lay emphasis on the importance of differentiating these two types of diabetes. Greater GV in the FCPD group was due to higher postprandial excursions than in T2D group. Additionally, defective incretin responses seen in T2D may also play a part in in postprandial increase in blood glucose levels in FCPD. This outcome could have a therapeutic application. There was no significant difference in the measures of hypoglycaemic indices between the two groups.
Limitations:
Certain limitations observed in the study included administration of CGM during hospitalization and there can be difference in results as opposed to home values. The dietary guidelines imparted during hospitalization could be different from that at home which could influence GV. Research with a larger sample size and more monitored glycaemic control should be conducted.
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