Ambulatory glycemic monitoring: own clinical decision-making experience

The introduction of outpatient glycemic monitoring into everyday practice significantly increased the ability to detect various forms of dysglycemia in patients with diabetes mellitus (DM) and prediabetes, and also contributed to improving the effectiveness of glycemic control. The purpose of the work: To study the frequency, nature and duration of dysglycemia episodes in patients with prediabetes and DM type 2, to reflect the impact of the results of outpatient glycemia monitoring on the choice of therapeutic strategy using the example of clinical observations. Materials and methods: The study included 59 patients, of which 48 were diagnosed with type 2 DM and 11 with prediabetes in the form of impaired glucose tolerance and impaired fasting glycemia. The average age of patients was, from and to years. Among the observed patients, there were 37 (62.7 %) men and 22 (37.2 %) women aged 30 to 76 years, with a mean age of (56.06 ± 11.44) years. All patients were on outpatient treatment, glycemic control was carried out through flash monitoring using the Freestyle libre 2 system. Assessment of disorders of the glycemic profile included studying the time in the target range, indicators of the average level and variability of glycemia, the frequency and duration of various episodes of dysglycemia: early postprandial hyperglycemia, hyperglycemic plateaus, episodes of latent hypoglycemia. The objective of the study was to demonstrate the clinical decision-making process in the management of patients with prediabetes and DM type 2 based on outpatient glucose monitoring data. Results and discussion: Different variants of dysglycemia were detected in all patients during monitoring, regardless of the time spent within the target glucose range. Clinical observations have shown that a change in therapeutic strategy based on data obtained during outpatient glucose monitoring leads to essential improvement in glycemic control. Conclusion: Outpatient glycemia monitoring is not only an opportunity for early detection of clinically significant carbohydrate metabolism disorders, but also an effective glycemia management tool in patients with prediabetes and type 2 DM.