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New Innovation: Use of Flash Glucose Monitoring for Evaluating Glycaemic Variability, Patient Satisfaction and Clinical Utility in Pregnant Women with Diabetes

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Abstract

Aim

Application of Flash glucose monitoring (FGM) system to evaluate glycaemic variability (GV), patient satisfaction and clinical utility in pregnant women with diabetes.

Methods

This prospective study was conducted in a tertiary care teaching hospital on 70 pregnant women with diabetes where blood sugar levels were monitored by FGM and self-monitoring of blood glucose (SMBG).

Results

FGM generated 19,950 readings versus 1470 readings by SMBG over 3 days. Glucose values measured by FGM and SMBG had significant positive correlation (r > 0.89; p < 0.001). Significant difference (p < 0.001) was present between minimum glucose values by FGM (52.49 ± 15.42 mg/dl) and SMBG (72.74 ± 18.30 mg/dl). FGM (20.9%) was able to pick exact duration of hypoglycaemia, while one-third of this duration was missed by conventional SMBG (14.7%; p < 0.05). Hypoglycaemic episodes were observed in 92.9% women by FGM as compared to 45.7% by SMBG (p < 0.001). No significant difference was observed in maximum glucose level or duration of hyperglycaemia by both methods. FGM identified hyperglycaemia in 74% women vs. 52% by SMBG (p < 0.001). GV calculated by using MODD by FGM was 118.4 ± 52.4 mg/dl and by SMBG was 83.2 ± 53.2 mg/dl (p < 0.001). 100% women preferred AGP vs. SMBG.

Conclusion

This is the first study to evaluate FGM for GV and patient satisfaction in women with GDM. Significant correlation was observed in glucose values by FGM and SMBG. FGM was more sensitive in detecting GV and hypoglycaemic excursions as compared to SMBG. All women preferred FGM over SMBG. Use of FGM gave new insights in clinical management of challenging cases.

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References

  1. Saxena P, Tyagi S, Prakash A, et al. Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of North India. Indian J Community Med [serial online]. 2011;36:120–3.

    Article  Google Scholar 

  2. Sallam NA, Palmgren VAC, Singh RD, et al. Programming of vascular dysfunction in the intrauterine milieu of diabetic pregnancies. Int J Mol Sci. 2018;19(11):E3665. https://doi.org/10.3390/ijms19113665.

    Article  CAS  PubMed  Google Scholar 

  3. Kalra S. Hypoglycaemia in diabetes. J Pak Med Assoc. 2014;64:1090–3.

    PubMed  Google Scholar 

  4. Suh S, Kim JH. Glycemic variability: how do we measure it and why is it important? Diabetes Metab J. 2015;39:273–82.

    Article  Google Scholar 

  5. Zaccardi F, Pitocco D, Ghirlanda G. Glycemic risk factors of diabetic vascular complications: the role of glycemic variability. Diabetes Metab Res Rev. 2009;25:199–207.

    Article  CAS  Google Scholar 

  6. Free Style Libre flash glucose monitoring system. Online [Cited 2015 May 30]. Available from URL:https://www.freestylelibre.co.uk/freestylelibre- reader-kit-mmol-l-en-gb.html.

  7. Chen R, Yogev Y, Ben-Haroush A, et al. Continuous glucose monitoring for the evaluation and improved control of gestational diabetes mellitus. J Matern Fetal Neonatal Med. 2003;14(4):256–60.

    Article  CAS  Google Scholar 

  8. Murphy HR, Rayman G, Lewis K, et al. Effectiveness of continuous glucose monitoring in pregnant women with diabetes: randomised clinical trial. BMJ. 2008;337:1680.

    Article  Google Scholar 

  9. Matthaei S. Assessing the value of the ambulatory glucose profile in clinical practice. Br J Diabetes Vasc Dis. 2014;14:148–52.

    Article  Google Scholar 

  10. Ratna S, Subashini R, Unnikrishnan R, et al. Use of freestyle libre ProTM flash glucose monitoring system in different clinical situations at a diabetes centre Bangalore. J Assoc Physicians India. 2017;65:18–23.

    PubMed  Google Scholar 

  11. Received FDA. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma_template.cfm?id=p150021 accessed on 3.5.2019

  12. https://abbott.mediaroom.com/2016-09-28-Abbott-Receives-FDA-Approval-for-the-FreeStyle-Libre-Pro-System-a-Revolutionary-Diabetes-Sensing-Technology-for-Healthcare-Professionals-to-Use-with-Their-Patients accessed on 20.7.2017

  13. Rawlings RA, Shi H, Yuan L-H, et al. Translating glucose variability metrics into the clinic via continuous glucose monitoring: a graphical user interface for diabetes evaluation (CGM-GUIDEª). Diabetes Technol Ther 2011;13(12):1241–8. https://doi.org/10.1089/dia.2011.0099

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. American Diabetes Association's Standards of Medical Care in Diabetes at https://care.diabetesjournals.org/content/diacare/suppl/2018/12/17/42.Supplement_1.DC1/DC_42_S1_2019_UPDATED.pdf. Accessed on 16/6/19

  15. Yu F, Lv L, Liang Z, et al. Continuous glucose monitoring effects on maternal glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus. J Clin Endocrinol Metab. 2014;99(12):4674–82. https://doi.org/10.1210/jc.2013-4332.

    Article  CAS  PubMed  Google Scholar 

  16. Alfadhli E, Osman E, Basri T. Use of a real time continuous glucose monitoring system as an educational tool for patients with gestational diabetes. Diabetol Metab Syndr. 2016;8:48. https://doi.org/10.1186/s13098-016-0161-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Kestila KK, Ekblad UU, Ronnemaa T. Continuous glucose monitoring versus self-monitoring of blood glucose in the treatment of gestational diabetes mellitus. Diabetes Res Clin Pract. 2007;77(2):174–9.

    Article  CAS  Google Scholar 

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Acknowledgements

This study was carried out through an academic grant awarded by the Delhi Diabetic Forum for procuring FreeStyle Libre flash glucose applicator and sensor for the enrolled patients.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Lady Hardinge Medical College & SSKH, New Delhi, 110017, India

    Saxena Pikee, Kumari Khushbu & Puri Manju

  2. Department of Medicine, Lady Hardinge Medical College & SSKH, New Delhi, 110017, India

    Prakash Anupam & Jain Sachin

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  1. Saxena Pikee
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Correspondence to Saxena Pikee.

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Conflict of interest

Authors have no conflict of interest in the findings of this study.

Ethical Approval

This study was initiated after approval from the Ethics Committee of Human Research of the Institute.

Humane and Animal Rights

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Saxena Pikee is a Professor in Department of Obstetrics and Gynecology, Lady Hardinge Medical College & SSKH, J-36 Saket, New Delhi, 110017, India; Kumari Khushbu is a Resident in Department of Obstetrics and Gynecology, Lady Hardinge Medical College & SSKH, J-36 Saket, New Delhi, 110017, India; Prakash Anupam is a Professor in Department of Medicine, Lady Hardinge Medical College & SSKH, New Delhi, India; Puri Manju is a Director Professor in Department of Obstetrics and Gynecology, Lady Hardinge Medical College & SSKH, J-36 Saket, New Delhi, 110017, India; Jain Sachin is a Director Professor in Department of Medicine, Lady Hardinge Medical College & SSKH, New Delhi, India

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Pikee, S., Khushbu, K., Anupam, P. et al. New Innovation: Use of Flash Glucose Monitoring for Evaluating Glycaemic Variability, Patient Satisfaction and Clinical Utility in Pregnant Women with Diabetes. J Obstet Gynecol India 71, 136–142 (2021). https://doi.org/10.1007/s13224-020-01391-9

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  • DOI: https://doi.org/10.1007/s13224-020-01391-9

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