Modest Improvement of Untreated Severe Sleep-Disordered Breathing in the Middle-Aged and Elderly

OBJECTIVE: It has been reported that untreated sleep-disordered breathing (SDB) deteriorates over time, however this remains contentious. The aim of the present study is to evaluate the clinical course of SDB in middle-aged and older SDB patients, and to identify how relevant factors contribute to the change in SDB severity. METHODS: Baseline and follow-up polysomnographic data of 56 untreated SDB patients (mean age, 61.2±5.71) were obtained retrospectively and the mean interval was 62.4±22.0 months. Subgroup analysis was performed based on the baseline severity, and the factors associated with the course of SDB were analyzed. RESULTS: At the baseline, 13 subjects were simple snorers, 15 had mild to moderate SDB, and 28 were severe SDB patients. While there was no significant change in apnea-hypopnea index (AHI) as a whole, subgroup analysis showed decrease of AHI in severe SDB patients (43.9±10.6 to 35.6±20.0, p=0.009). The change in supine time percent and baseline AHI were associated with the change in AHI (β=0.387, p=0.003; β=-0.272, p=0.037). CONCLUSION: Untreated SDB did not deteriorate over time with modest improvement in severe SDB. A proportion of severe SDB patients might expect decrease in SDB severity irrespective of changes in sleep position or body weight.

The Education Effect of Glucometer Use on the Glucose Levels and the Glucose Value Comparison among Diverse Glucometers / 임상당뇨병

Self-monitoring of blood glucose (SMBG) and point-of-care testing are widely used in the management of diabetic outpatients. However, SMBG records are sometimes inaccurate, and may differ from glucose values measured in the hospital. Therefore, the aim of our study was to evaluate the effects of patient education regarding glucometer use on blood glucose levels and to compare the glucose values obtained by six different types of glucometers currently used in Korea. Fifty-six diabetic patients participated in the present study. Each patient visited the hospital in a fasting state. Fasting plasma glucose (FPG) levels in capillary blood samples were measured by doctors and by the patients themselves before and after patient education sessions. Then, glucose levels were measured with each of the six glucometers by doctors and by the patients themselves. The differences between FPG and glucose values measured using glucometers were compared, and their relationships with HbA1c were also assessed. There were no significant differences between glucose levels measured by patients regardless of glucometer education. We obtained similar results for differences between glucose levels measured by patients and doctors. Patient HbA1c levels were not correlated with differences in measurements between glucometers and FPG. Measurements of glucose levels by the six different glucometers did not differ significantly. Our study indicates that education about SMBG, including glucometer handling, is important to increase SMBG accuracy, but that errors in SMBG records are trivial for glucometer users and that the different glucometers used in Korea demonstrate similar accuracy.