Flash Glucose Monitoring Improves Glucose Control in People with Type 2 Diabetes Mellitus Receiving Anti-diabetic Drug Medication

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), glucosevariations, and incidence of hypoglycemia during the FGM period. The multivariate linear stepwise regression analysis was applied to determine the independentfactors 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; HbA1 c: 61.2 +/- 13.3 mmol/mol; body mass index(BMI): 25.2 +/- 3.2 kg/m(2) . Using FGM, people with T2DM were ableto 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 glucosevariations, 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 HbA1 c (high, middle, and low concentrations), the reduction of MPG in patients with high concentration of HbAl c 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 euglycemiawas 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).

Automated summary

Using Flash Glucose Monitoring (FGM) to monitor glucose levels can help people with Type 2 Diabetes Mellitus (T2DM) achieve better glucose control through adjustments in daily diet and exercise without changing medication.