Home > DGMS > 15. What are the special clinical significances of DGMS?
1) The traditional viewpoint is that, for type 1 diabetics the ideal control of overall glucose is a standard range of control in glucose and HbA1c (Hemoglobin A1c). Using DGMS, we discover that the incidence of hypoglycemia and hyperglycemia happened only occasionally on those patients with normal HbA1c. Even out of the patients treated with insulin, whose glucose and HbA1c before meals were normal, 90% had a post-prandial glucose level higher than 10mmol/L, 50% had a post-prandial glucose level higher than16.7 mmol/L, and 70% had non-symptom hypoglycemia at night. The reason is that post-prandial hyperglycemia and non-symptom hypoglycemia can counteract each other, so that HbA1c appears to be normal. Therefore, it is unreliable only to use the HbA1c to indicate the glucose.
2) For people with normal glucose, the glucose change detected with DGMS was lower at night and before meals; the daily glucose peak occurred one to two hours after meals, especially lunch and dinner. The glucose value of forty-three people was higher than 7.8 mmol/L, accounting for 63%, and 21% of the people’s glucose drifted to lower than 2.8mmol/L. It’s obvious that with DGMS, understanding the healthy people’s glucose fluctuation changes is significant for the study of glucose values’ dividing points in diabetes mellitus diagnosis, and controlling impaired glucose.
3) Using DGMS, we monitored forty diabetics over a period of 72 hours and found that glucose values were relatively high during the two hours after breakfast, and the three hours after lunch and supper; they were the lowest between 1:00 am and 6:00 am—the period of time when blood glucose values of 7.8mmol/L and 11.1mmol/L accounted for 96% and 63% respectively of the forty diabetics, which were related highly to HbAlc. Testing reports for dynamic glucose using DGMS in seniors indicate that the incidence of hypoglycemia was 0.62±0.72 times/day and blood glucose that tested lower than 2.2mmol/L accounted for 3.3% of a day.
4) It is common knowledge in the diabetic community that gestational diabetes and diabetic gestation carry the following risks:
· overdeveloped embryos
· Newborn hypoglycemia
· Lethal damage to embryo
· infant mortality in perinatal period
· pre-eclampsia
Dr.Kerssen’s research on nine women in the early stages of pregnancy shows HbAlc<7.0% (point of previous data unclear), but the area where the glucose values are under the curve of >7.8mmol/L accounted for 52.8%, and the area in which glucose values were lower than 3.9mmol/L accounted for 41.2%, both of which could not be discovered without the use of DGMS.
Dr.Ben-Norush discovered with DGMS that the glucose peak appeared 90 minutes after meals, and that 10% of hypoglycemia occurred at 160 minutes after meals. The incidence of non-symptom hypoglycemia reached 63% when treated with insulin at night, and 4.2±1 times/day in the daytime.
5) The application of DGMS in diabetes-related complications:
With DGMS, it was found that ten out of fifty-four patients with hypoglycemia who experienced coronary also felt chest pains; four of the fifty-four had a cardiogram myocardial ischemia at the same time, while only one patient experienced chest pain out of fifty-nine hyperglycemia events. Using DGMS, it became clear that hypoglycemia induces heart angina more readily than hyperglycemia.
6) The curative effect and treatment method with DGMS:
The most outstanding therapy is insulin beta cell transplant; the second is insulin pumps that treatment, and the least is oral medicine.
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