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Cited by 137Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes Management and Education

Glycemic Characteristics in Continuously Monitored Patients With Type 1 and Type 2 Diabetes

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Bode, Bruce W., Schwartz, Sherwyn, Stubbs, Harrison A., Block, Jon E.·2005·Diabetes Care
DOI 10.2337/diacare.28.10.2361
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Abstract

OBJECTIVE—The purpose of this study was to generate normative values for periods of euglycemia as well as for daily patterns of glycemic excursions in patients with type 1 and type 2 diabetes monitored continuously for a maximum period of 21 days and blinded to glucose levels. RESEARCH DESIGN AND METHODS—This was a multicenter, prospective observational study in which 101 consecutive patients with type 1 (n = 60) or type 2 (n = 41) diabetes underwent blinded continuous glucose monitoring. Serial glucose measurements were divided into periods of euglycemia (70–180 mg/dl), hyperglycemia (>180 mg/dl), and hypoglycemia (<70 mg/dl). The proportions of time patients were hypoglycemic, euglycemic, and hyperglycemic and the total areas under the curves (AUCs) were determined. RESULTS—During the observation period the 101 subjects contributed an average 287 ± 132 h of continuous glucose values. Subjects remained in the euglycemic range for ∼63% of the total day, were hypoglycemic 8%, and were hyperglycemic 29%. Hypoglycemia was more prevalent nocturnally (11 vs. 7%) and hyperglycemia diurnally (31 vs. 25%). Compared with subjects with type 2 diabetes, type 1 diabetic subjects had more frequent hypoglycemic episodes per day (2.1 vs. 1.0; P < 0.001) that were of longer duration (1.1 vs. 0.7 h; P < 0.0001), reflecting a greater number of hours per day in the hypoglycemic range (2.3 vs. 1.0 h; P < 0.0001). The mean hypoglycemic AUC values were >150% higher for type 1 compared with type 2 diabetic subjects (41 vs. 16, respectively; P < 0.0001). CONCLUSIONS—These normative data will assist in study and sample size planning for future investigations of continuous glucose monitoring and allow for qualitative comparisons with trials of therapeutic interventions aimed at reducing the occurrence of glycemic excursions.

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  • Even with frequent BGM, most people with type 1 diabetes have undetected and unacceptably high frequency of hyper- and hypoglycemia.

    “However, even with frequent BGM, most people with type 1 diabetes will have undetected and an unacceptable high frequency of hyper-and hypoglycemia (72).”

    From The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2021) · cites this paper as [72]

    The Results report frequent fingerstick testing (about nine times daily), substantial hyperglycemia and more than two hours per day of hypoglycemia among subjects with type 1 diabetes. The discussion says nocturnal hypoglycemia often goes undetected by standard monitoring and postprandial hyperglycemia is underappreciated by conventional monitoring. But the paper describes these patterns in an intensively managed study cohort; it does not establish that most people with type 1 diabetes experience both at this frequency. (LLM, conf=0.85)

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  • Self-monitoring of blood glucose is associated with an improvement in control of HbA1c, but the information it provides is limited, and people living with diabetes may be unaware of their glucose levels or trends, leading to an increased risk of hypoglycemic events.

    “Of note, although self-monitoring of blood glucose is associated with an improvement in control of HbA1c, the information it provides is limited, and people living with diabetes may be unaware of their glucose levels or trends, leading to an increased risk of hypoglycemic events.2-4”

    From Importance of FDA-integrated continuous glucose monitors to ensure accuracy of continuous glucose monitoring (2025) · cites this paper as [4]

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Authors
Bode, B. W., Schwartz, S., Stubbs, H. A., & Block, J. E.
Affiliations
  • Atlanta Diabetes Associates (US)
  • Diabetes & Glandular Disease Clinic (US)
  • Oakland, California
  • San Francisco, California
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2005-10-01
Volume
28
Issue
10
Pages
2361-2366
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.28.10.2361
OpenAlex
W2095240021
Cited by
137
References
39
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 6 · 2018: 6 · 2017: 6 · 2016: 4 · 2015: 8 · 2014: 4 · 2013: 7 · 2012: 4
FWCI
5.80
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
type 1 diabetes, type 2 diabetes, continuous glucose monitoring, glycemic excursions, hypoglycemia, hyperglycemia, normoglycemia, reference values, time in range, nocturnal hypoglycemia, glycemic variability
MeSH terms
Adult, Circadian Rhythm, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Hyperglycemia, Hypoglycemia, Male, Middle Aged, Monitoring, Physiologic, Obesity, Prospective Studies

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