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Evaluation of glycemic variability in chronic liver disease patients with type 2 diabetes mellitus using continuous glucose monitoring. | LitMetric

AI Article Synopsis

  • Chronic liver disease (CLD) patients show significant fluctuations in blood glucose levels, which are not well understood, prompting a study using continuous glucose monitoring (CGM) to evaluate these variations.
  • The study involved 105 CLD patients with type 2 diabetes, revealing that worsening liver function correlates with increased mean blood glucose and greater differences between high and low glucose levels, indicating serious glycemic variability.
  • The findings highlight that CGM can uncover hidden glucose abnormalities, particularly in non-anemic CLD patients with lower HbA1c levels, helping to better manage diabetes in this population.

Article Abstract

Background And Aims: The feature of blood glucose dynamics in patients with chronic liver disease (CLD) is marked blood glucose fluctuations. However, the detail of blood glucose dynamics is not well known. The aim of the present study was to evaluate glycemic fluctuations by continuous glucose monitoring (CGM).

Materials And Methods: A total of 105 CLD patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. Various parameters of glycemic variability were evaluated. The association of these parameters with liver functional reserve was examined. The parameters were also evaluated according to glycated hemoglobin A1c (HbA1c) levels.

Results And Discussion: Data of all patients showed that mean blood glucose (MBG) levels and the difference between highest and lowest blood glucose (ΔBG) increased significantly with worsening of liver functional reserve (P < 0.001 and P = 0.005, respectively). Although many of the cases were being treated for diabetes, postprandial hyperglycemia was seen in 92% of patients. Nocturnal hypoglycemia was seen in 22% of patients. In non-anemic patients with HbA1c levels of < 7.0%, the percentage of patients with mean amplitude of glycemic excursion (MAGE) of ≥ 77.4 mg/dL and that of MBG levels of > 145 mg/dL were higher in liver cirrhosis (LC) patients than in chronic hepatitis (CH) patients. In them, homeostasis model assessment for insulin resistance (HOMA-IR) of > 2.5 and LC were significantly associated with the increase in MAGE. LC was also significantly associated with increased MBG levels.

Conclusion: The CGM systems were useful in finding hidden abnormalities of blood glucose fluctuations in CLD patients with T2DM, especially in non-anemic CLD patients with HbA1c levels of < 7.0%.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882130PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195028PLOS

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