ABSTRACT
AIMS: Hyperglycemia is the major factor underlying vascular complications of diabetes. Unfortunately, improved glycemia control is frequently accompanied by an increased risk of hypoglycemia. The aim of the study was to assess the relationship between hemoglobin A1c (HbA1c) and 1-week Continuous Glucose Monitoring (CGM) data in long-standing type 1 diabetes (T1DM). METHODS: We recruited 58 subjects with long-standing T1DM consecutively enrolled to the study. Each patient underwent a 1-week CGM and laboratory profile at baseline. Subjects were divided into three subgroups according to baseline HbA1c tertiles: T1â¯<â¯7.1%, T2â¯=â¯7.1-8.0%, and T3â¯>â¯8.0%. RESULTS: T1 patients were characterized by the longest time in range (66% of a week), whereas T3 patients experienced hyperglycemia in >50% time of the week. T1 patients were noted to have 25% of nighttime with glycemia <3.9â¯mmol/L (8% with glycemia <2.8â¯mmol/L). Most recent HbA1c closely reflected 10-years mean HbA1c values (Râ¯=â¯0.83; Pâ¯<â¯0.0001). CONCLUSIONS: (1) Long-term diabetes control (10â¯years HbA1c mean) is a strong predictor of the current HbA1c levels. (2) Current and historical HbA1c levels are closely linked to CGM-derived glycemia. (3) Risk of clinically significant hypoglycemia negatively correlates with HbA1c. (4) HbA1câ¯>â¯8.0% is associated with unsatisfactorily low (44%) time in range.
Subject(s)
Blood Glucose/analysis , Diabetes Mellitus, Type 1/blood , Glycated Hemoglobin/metabolism , Hypoglycemia/blood , Adult , Aged , Blood Glucose/metabolism , Blood Glucose Self-Monitoring , Cardiovascular Diseases/blood , Cardiovascular Diseases/etiology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/pathology , Diabetic Angiopathies/blood , Diagnostic Tests, Routine , Disease Progression , Female , Follow-Up Studies , Glycated Hemoglobin/analysis , Humans , Hypoglycemia/diagnosis , Hypoglycemia/etiology , Male , Middle Aged , Patient Care Planning , Risk Factors , Time FactorsABSTRACT
An effect of replacing conventional forms of insulin by the monocomponent insulin manufactured by "Polfa" was studied in the group of 22 diabetics. The patients were followed up for 12 months. An effect of monocomponent insulin on daily requirement of insulin, levels of anti-insulin, monocomponent and pancreatic peptide antibodies, compensation of diabetes mellitus, and lipodystrophy were investigated. New insulin preparation decreased anti-insulin and pancreatic peptide antibodies level and markedly diminished lipodystrophy. However, daily insulin requirement, degree of diabetes mellitus compensation, and anti-proinsulin antibodies level remained unchanged.
