Glycemic Variability in Type 1 Diabetes Mellitus Saudis Using Ambulatory Glucose Profile

Bader Alzahrani; Saad Alzahrani; Mussa H Almalki; Souha S Elabd; Shawana Abdulhamid Khan; Badurudeen Buhary; Naji Aljuhani; Anwar A Jammah

doi:10.1177/11795514211013789

Glycemic Variability in Type 1 Diabetes Mellitus Saudis Using Ambulatory Glucose Profile

Clin Med Insights Endocrinol Diabetes. 2021 May 5:14:11795514211013789. doi: 10.1177/11795514211013789. eCollection 2021.

Authors

Bader Alzahrani^{1

2}, Saad Alzahrani¹, Mussa H Almalki¹, Souha S Elabd¹, Shawana Abdulhamid Khan¹, Badurudeen Buhary¹, Naji Aljuhani¹, Anwar A Jammah³

Affiliations

¹ Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
² Department of Family Medicine, Security Forces Hospital Program, Riyadh, Kingdom of Saudi Arabia.
³ Endocrinology and Diabetes Units, Department of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.

Abstract

Background: Glucose variability (GV) is a common and challenging clinical entity in the management of people with type 1 diabetes (T1DM). The magnitude of GV in Saudi people with T1DM was not addressed before. Therefore, we aimed to study GV in a consecutive cohort of Saudis with T1DM.

Methods: We prospectively assessed interstitial glucose using FreeStyle^® Libre flash glucose monitoring in people with TIDM who attended follow-up in the diabetes clinics at King Fahad Medical City between March and June 2017. Glycemia profile, standard deviation (SD), coefficient of variation (CV), mean of daily differences (MODD), and mean amplitude of glucose excursion (MAGE) were measured using the standard equations over a period of 2 weeks.

Results: Fifty T1DM subjects (20 males) with mean age 20.2 ± 6.1 years and mean fortnight glucose 192 ± 42.3 mg/dl were included. The mean SD of 2-week glucose readings was 100.4 ± 36.3 mg/dl and CV was 52.1% ± 13%. Higher levels of glucose excursions were also observed. MODD and MAGE were recorded as 104.5 ± 51.7 and 189 ± 54.9 mg/dl, respectively which is 2 to 4 times higher than the international standards. Higher MODD and MAGE were observed on weekends compared to weekdays (111.3 ± 62.1 vs 98.6 ± 56.2 mg/dl and 196.4 ± 64.6 vs 181.7 ± 52.4 mg/dl, respectively; P ⩽ .001).

Conclusion: Higher degree of glycemic variability was observed in this cohort of TIDM Saudis. Weekends were associated with higher glucose swings than weekdays. More studies are needed to explore these findings further.

Keywords: Ambulatory glucose profile; coefficient of variation; glycemic variability; mean amplitude of glycemic excursion; standard deviation; type 1 diabetes.