Rikke Borg - Academia.edu (original) (raw)
Papers by Rikke Borg
BMJ Open
IntroductionDiabetic kidney disease is a severe complication of diabetes. The diagnosis is based ... more IntroductionDiabetic kidney disease is a severe complication of diabetes. The diagnosis is based on clinical characteristics such as persistently elevated albuminuria, hypertension and decline in kidney function, although this definition is not specific to kidney disease caused by diabetes. The only way to establish an accurate diagnosis—diabetic nephropathy—is by performing a kidney biopsy. The histological presentation of diabetic nephropathy can be associated with a heterogeneous range of histological features with many pathophysiological factors involved demonstrating the complexity of the condition. Current treatment strategies aim to slow disease progression and are not specific to the underlying pathological processes.This study will investigate the prevalence of diabetic nephropathy in individuals with type 2 diabetes (T2D) and severely elevated albuminuria. The deep molecular characterisation of the kidney biopsy and biological specimens may pave the way for improved diagno...
Indian Journal of Medical Research
Journal of Antimicrobial Chemotherapy
ObjectivesIn the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin... more ObjectivesIn the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin or clindamycin is investigated in patients receiving chronic haemodialysis (HD). However, data on plasma concentrations of these antibiotics during HD are sparse. This study aims to determine if the plasma concentration of amoxicillin and clindamycin is sufficient during HD after oral administration of amoxicillin and clindamycin at three different time intervals prior to the HD procedure.MethodsAdult patients receiving chronic HD were investigated twice with an interval of at least 7 days starting with either a tablet of 500/125 mg amoxicillin/clavulanic acid or a tablet of 600 mg clindamycin. Patients were randomized to take the antibiotics either 30, 60 or 120 min prior to the HD procedure. Plasma antibiotic concentrations were measured at start, midway and at the end of HD. A lower threshold was set at 2.0 mg/L for amoxicillin and at 1.0 mg/L for clindamycin. In addition, a populati...
BMJ Open, 2017
The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a ran... more The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a randomised clinical trial (MAGiCAL-CKD): essential study design and rationale. BMJ Open 2017;7:e016795.
International Journal of Nephrology
Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chroni... more Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chronic diseases. The World Health Organization projects CKD to become the 5th most common chronic disease in 2040. Causes of CKD are multifactorial and diverse, but early-stage symptoms are often few and silent. Progression rates are highly variable, but patients encounter both an increased risk for end-stage kidney disease (ESKD) as well as increased cardiovascular risk. End-stage kidney disease incidence is generally low, but every single case carries a significant burden of illness and healthcare costs, making prevention by early intervention both desirable and worthwhile. This review focuses on the prevalence, diagnosis, and causes of CKD. In addition, we discuss the developments in the general treatment of CKD, with particular attention to what can be initiated in general practice. With the addition of recent landmark findings and the expansion of the indication for using sodium–glucose ...
Nephrology Dialysis Transplantation, May 1, 2022
Ugeskrift for Læger, Apr 18, 2022
Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose toleran... more Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods. Methods We assessed the prevalence of cardiovascular risk factors in individuals with undiagnosed diabetes according to the WorldHealthOrganizationclassificationorbythenewlyproposedHbA1clevel ‡ 6.5%among6258participantsoftheDanish Inter99 study. Receiver operating curve analysis assessed the ability of fasting: 2-h plasma glucose and HbA1c to distinguish between individuals at high and low risk of ischemic heart disease, predicted by the PRECARD program. Results Prevalence of undiagnosed diabetes was 4.1% [95% confidence interval (CI) 3.7‐4.7%] by the current oral glucose tolerance test definition, whereas 6.6% (95% CI 6.0‐7.2%) had diabetes by HbA1c levels. HbA1c-defined individuals were relatively older with higher proportions of men, smokers, lipid a...
Diabetes Care, 2009
WSTEP. Oznaczanie HbA1c, wyra?one jako procent hemoglobiny glikowanej, pozwala na d³ugoterminow± ... more WSTEP. Oznaczanie HbA1c, wyra?one jako procent hemoglobiny glikowanej, pozwala na d³ugoterminow± ocene glikemii i jest stosowane do oceny skuteczno¶ci leczenia cukrzycy oraz korekty terapii. Codzienna ocena kontroli glikemii opiera sie na samodzielnym monitorowaniu ste?en glukozy we krwi naczyn w³osowatych (mg/dl lub mmol/l). W przedstawionym badaniu poszukiwano matematycznej zale?no¶ci pomiedzy odsetkiem HbA1c i ¶rednim ste?eniem glukozy (AG) oraz probowano okre¶liae, czy ste?enie HbA1c mo?e byae wyra?ane jako AG w takich samych jednostkach, jak wielko¶ci u?ywane do samodzielnego monitorowania. MATERIA£ I METODY. Do analizy w³±czono 507 pacjentow: 268 chorych na cukrzyce typu 1, 159 chorych na cukrzyce typu 2 i 80 osob bez cukrzycy, z 10 miedzynarodowych o¶rodkow badawczych. Warto¶ci HbA1c otrzymane na koncu 3-miesiecznego okresu odczytywano w centralnym laboratorium i porownywano ze ste?eniami AG w okresie poprzednich 3 miesiecy. ¦rednie ste?enie glukozy obliczano poprzez zsumowan...
OBJECTIVE — The A1C assay, expressed as the percent of hemoglobin that is glycated, measures chro... more OBJECTIVE — The A1C assay, expressed as the percent of hemoglobin that is glycated, measures chronic glycemia and is widely used to judge the adequacy of diabetes treatment and adjust therapy. Day-to-day management is guided by self-monitoring of capillary glucose con-centrations (milligrams per deciliter or millimoles per liter). We sought to define the mathemat-ical relationship between A1C and average glucose (AG) levels and determine whether A1C could be expressed and reported as AG in the same units as used in self-monitoring. RESEARCH DESIGN AND METHODS — A total of 507 subjects, including 268 pa-tients with type 1 diabetes, 159 with type 2 diabetes, and 80 nondiabetic subjects from 10 international centers, was included in the analyses. A1C levels obtained at the end of 3 months and measured in a central laboratory were compared with the AG levels during the previous 3 months. AG was calculated by combining weighted results from at least 2 days of continuous glucose monitoring performed four times, with seven-point daily self-monitoring of capillary (fingerstick) glucose performed at least 3 days per week. RESULTS — Approximately 2,700 glucose values were obtained by each subject during 3 months. Linear regression analysis between the A1C and AG values provided the tightest cor-
Diabetic Medicine, 2018
Research: Epidemiology Interpretation of HbA 1c in primary care and potential influence of anaemi... more Research: Epidemiology Interpretation of HbA 1c in primary care and potential influence of anaemia and chronic kidney disease: an analysis from the Copenhagen Primary Care Laboratory (CopLab)
Diabetic Medicine, 2010
Aims Glycated haemoglobin (HbA 1c) has been proposed as an alternative to the oral glucose tolera... more Aims Glycated haemoglobin (HbA 1c) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods. Methods We assessed the prevalence of cardiovascular risk factors in individuals with undiagnosed diabetes according to the World Health Organization classification or by the newly proposed HbA 1c level ‡ 6.5% among 6258 participants of the Danish Inter99 study. Receiver operating curve analysis assessed the ability of fasting: 2-h plasma glucose and HbA 1c to distinguish between individuals at high and low risk of ischemic heart disease, predicted by the PRECARD program. Results Prevalence of undiagnosed diabetes was 4.1% [95% confidence interval (CI) 3.7-4.7%] by the current oral glucose tolerance test definition, whereas 6.6% (95% CI 6.0-7.2%) had diabetes by HbA 1c levels. HbA 1c-defined individuals were relatively older with higher proportions of men, smokers, lipid abnormalities and macro-albuminuria, but they were leaner and had lower blood pressure. HbA 1c was better than fasting-and 2-h plasma glucose at distinguishing between individuals of high and low predicted risk of ischaemic heart disease; however, the difference between HbA 1c and fasting-and 2-h plasma glucose was not statistically significant. Conclusions Compared with the current oral glucose tolerance test definition, more individuals were classified as having diabetes based on the HbA 1c criteria. This group had as unfavourable a risk profile as those identified by the oral glucose tolerance test.
Annals of Translational Medicine, 2021
Diabetic kidney disease is a frequent and costly complication to type 2 diabetes. After many year... more Diabetic kidney disease is a frequent and costly complication to type 2 diabetes. After many years with a lack of successful trials there are now significant developments that will change treatment, guidelines and future outcome. Since the last two decades blockade of the renin-angiotensin system (RAS) is standard treatment, but new antidiabetic treatments have shown potential for kidney protection. After cardiovascular outcome studies with glucagon-like peptide (GLP-1) receptor agonists it is evident that drugs like liraglutide, semaglutide and dulaglutide can reduce albuminuria levels and progression to macroalbuminuria. At present, a renal outcome trial with semaglutide is ongoing which will provide more evidence on the drug class in the future. The sodium glucose co-transporter 2 (SGLT2) inhibitor class has also demonstrated effects beyond glucose-lowering, as the drugs can reduce blood pressure, albuminuria and loss of renal function. In the first renal outcome study the SGLT2 inhibitor canagliflozin was found to reduce the risk of hard renal outcome with 30%. SGLT2 inhibition is now recommended in type 2 diabetes with chronic kidney disease. Renal outcome studies testing additional SGLT2 inhibitors and the GLP-1 receptor agonist semaglutide will report in the coming future potentially providing more and much needed options for treatment.
Diabetologia, 2010
Aims Increased glucose excursions and postprandial hyperglycaemia have been suggested as unique r... more Aims Increased glucose excursions and postprandial hyperglycaemia have been suggested as unique risk factors for cardiovascular disease (CVD) and mortality in patients with diabetes mellitus. Much of the evidence is based on a single 2 h glucose value after oral glucose tolerance testing in epidemiological studies. We examined the association between various indices of glycaemia measured during everyday activities and metabolic CVD risk factors in the A1C-Derived Average Glucose (ADAG) study. Methods Participants (268 with type 1 diabetes, 159 with type 2 diabetes) completed 16 weeks of intensive continuous glucose monitoring (CGM) and self-monitoring of blood glucose (SMBG). From these data, common indices of postprandial glycaemia, overall hyperglycaemia, glucose variability and HbA 1c were derived. The associations between glycaemic indices and known CVD risk factors (lipids, high-sensitivity C-reactive protein and blood pressure) were explored in linear regression models. Results For both diabetes types, the overall strongest associations with CVD risk factors were seen for the measures of average glycaemia (mean blood glucose and HbA 1c). Associations between self-monitored postprandial and fasting glucose and CVD risk factors were weaker, but significant. Measurements of blood glucose variability showed non-significant associations. Overall, calculations based on CGM were not more informative than those based on frequent SMBG. Conclusions/interpretation Mean glycaemia and HbA 1c show consistent and stronger associations with CVD risk factors than fasting glucose or postprandial glucose levels or measures of glucose variability in patients with diabetes. Keywords ADAG study. CVD risk. Glucose monitoring. Glucose variability. HbA 1c. Postprandial glycaemia. z score Abbreviations ADAG A1C-Derived Average Glucose study BG Blood glucose CGM Continuous glucose monitoring The Electronic supplementary material (ESM) contains a list of members of the ADAG Study Group Electronic supplementary material The online version of this article
Nephrology Dialysis Transplantation, 2018
Diabetologia, 2010
Aims/hypothesis Real-life glycaemic profiles of healthy individuals are poorly studied. Our aim w... more Aims/hypothesis Real-life glycaemic profiles of healthy individuals are poorly studied. Our aim was to analyse to what extent individuals without diabetes exceed OGTT thresholds for impaired glucose tolerance (IGT) and diabetes. Methods In the A1C-Derived Average Glucose (ADAG) study, 80 participants without diabetes completed an intensive glucose monitoring period of 12 weeks. From these data, we calculated the average 24 h glucose exposure as time spent above different plasma glucose thresholds. We also derived indices of postprandial glucose levels, glucose variability and HbA 1c. Results We found that 93% of participants reached glucose concentrations above the IGT threshold of 7.8 mmol/l and spent a median of 26 min/day above this level during continuous glucose monitoring. Eight individuals (10%) spent more than 2 h in the IGT range. They had higher HbA 1c , fasting plasma glucose (FPG), age and BMI than those who did not. Seven participants (9%) reached glucose concentrations above 11.1 mmol/l during monitoring. Conclusions/interpretation Even though the non-diabetic individuals monitored in the ADAG study were selected on the basis of a very low level of baseline FPG, 10% of these spent a considerable amount of time at glucose levels considered to be 'prediabetic' or indicating IGT. This highlights the fact that exposure to moderately elevated glucose levels remains under-appreciated when individuals are classified on the basis of isolated glucose measurements. Keywords Continuous glucose monitoring. Glucose monitoring. Glycaemia in healthy individuals. Non-diabetic glucose exposure. Normoglycaemia Abbreviations ADAG A1C-Derived Average Glucose CGM Continuous interstitial glucose monitoring FPG Fasting plasma glucose IGT Impaired glucose tolerance IQR Interquartile range Electronic supplementary material The online version of this article
BMJ Open
IntroductionDiabetic kidney disease is a severe complication of diabetes. The diagnosis is based ... more IntroductionDiabetic kidney disease is a severe complication of diabetes. The diagnosis is based on clinical characteristics such as persistently elevated albuminuria, hypertension and decline in kidney function, although this definition is not specific to kidney disease caused by diabetes. The only way to establish an accurate diagnosis—diabetic nephropathy—is by performing a kidney biopsy. The histological presentation of diabetic nephropathy can be associated with a heterogeneous range of histological features with many pathophysiological factors involved demonstrating the complexity of the condition. Current treatment strategies aim to slow disease progression and are not specific to the underlying pathological processes.This study will investigate the prevalence of diabetic nephropathy in individuals with type 2 diabetes (T2D) and severely elevated albuminuria. The deep molecular characterisation of the kidney biopsy and biological specimens may pave the way for improved diagno...
Indian Journal of Medical Research
Journal of Antimicrobial Chemotherapy
ObjectivesIn the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin... more ObjectivesIn the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin or clindamycin is investigated in patients receiving chronic haemodialysis (HD). However, data on plasma concentrations of these antibiotics during HD are sparse. This study aims to determine if the plasma concentration of amoxicillin and clindamycin is sufficient during HD after oral administration of amoxicillin and clindamycin at three different time intervals prior to the HD procedure.MethodsAdult patients receiving chronic HD were investigated twice with an interval of at least 7 days starting with either a tablet of 500/125 mg amoxicillin/clavulanic acid or a tablet of 600 mg clindamycin. Patients were randomized to take the antibiotics either 30, 60 or 120 min prior to the HD procedure. Plasma antibiotic concentrations were measured at start, midway and at the end of HD. A lower threshold was set at 2.0 mg/L for amoxicillin and at 1.0 mg/L for clindamycin. In addition, a populati...
BMJ Open, 2017
The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a ran... more The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a randomised clinical trial (MAGiCAL-CKD): essential study design and rationale. BMJ Open 2017;7:e016795.
International Journal of Nephrology
Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chroni... more Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chronic diseases. The World Health Organization projects CKD to become the 5th most common chronic disease in 2040. Causes of CKD are multifactorial and diverse, but early-stage symptoms are often few and silent. Progression rates are highly variable, but patients encounter both an increased risk for end-stage kidney disease (ESKD) as well as increased cardiovascular risk. End-stage kidney disease incidence is generally low, but every single case carries a significant burden of illness and healthcare costs, making prevention by early intervention both desirable and worthwhile. This review focuses on the prevalence, diagnosis, and causes of CKD. In addition, we discuss the developments in the general treatment of CKD, with particular attention to what can be initiated in general practice. With the addition of recent landmark findings and the expansion of the indication for using sodium–glucose ...
Nephrology Dialysis Transplantation, May 1, 2022
Ugeskrift for Læger, Apr 18, 2022
Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose toleran... more Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods. Methods We assessed the prevalence of cardiovascular risk factors in individuals with undiagnosed diabetes according to the WorldHealthOrganizationclassificationorbythenewlyproposedHbA1clevel ‡ 6.5%among6258participantsoftheDanish Inter99 study. Receiver operating curve analysis assessed the ability of fasting: 2-h plasma glucose and HbA1c to distinguish between individuals at high and low risk of ischemic heart disease, predicted by the PRECARD program. Results Prevalence of undiagnosed diabetes was 4.1% [95% confidence interval (CI) 3.7‐4.7%] by the current oral glucose tolerance test definition, whereas 6.6% (95% CI 6.0‐7.2%) had diabetes by HbA1c levels. HbA1c-defined individuals were relatively older with higher proportions of men, smokers, lipid a...
Diabetes Care, 2009
WSTEP. Oznaczanie HbA1c, wyra?one jako procent hemoglobiny glikowanej, pozwala na d³ugoterminow± ... more WSTEP. Oznaczanie HbA1c, wyra?one jako procent hemoglobiny glikowanej, pozwala na d³ugoterminow± ocene glikemii i jest stosowane do oceny skuteczno¶ci leczenia cukrzycy oraz korekty terapii. Codzienna ocena kontroli glikemii opiera sie na samodzielnym monitorowaniu ste?en glukozy we krwi naczyn w³osowatych (mg/dl lub mmol/l). W przedstawionym badaniu poszukiwano matematycznej zale?no¶ci pomiedzy odsetkiem HbA1c i ¶rednim ste?eniem glukozy (AG) oraz probowano okre¶liae, czy ste?enie HbA1c mo?e byae wyra?ane jako AG w takich samych jednostkach, jak wielko¶ci u?ywane do samodzielnego monitorowania. MATERIA£ I METODY. Do analizy w³±czono 507 pacjentow: 268 chorych na cukrzyce typu 1, 159 chorych na cukrzyce typu 2 i 80 osob bez cukrzycy, z 10 miedzynarodowych o¶rodkow badawczych. Warto¶ci HbA1c otrzymane na koncu 3-miesiecznego okresu odczytywano w centralnym laboratorium i porownywano ze ste?eniami AG w okresie poprzednich 3 miesiecy. ¦rednie ste?enie glukozy obliczano poprzez zsumowan...
OBJECTIVE — The A1C assay, expressed as the percent of hemoglobin that is glycated, measures chro... more OBJECTIVE — The A1C assay, expressed as the percent of hemoglobin that is glycated, measures chronic glycemia and is widely used to judge the adequacy of diabetes treatment and adjust therapy. Day-to-day management is guided by self-monitoring of capillary glucose con-centrations (milligrams per deciliter or millimoles per liter). We sought to define the mathemat-ical relationship between A1C and average glucose (AG) levels and determine whether A1C could be expressed and reported as AG in the same units as used in self-monitoring. RESEARCH DESIGN AND METHODS — A total of 507 subjects, including 268 pa-tients with type 1 diabetes, 159 with type 2 diabetes, and 80 nondiabetic subjects from 10 international centers, was included in the analyses. A1C levels obtained at the end of 3 months and measured in a central laboratory were compared with the AG levels during the previous 3 months. AG was calculated by combining weighted results from at least 2 days of continuous glucose monitoring performed four times, with seven-point daily self-monitoring of capillary (fingerstick) glucose performed at least 3 days per week. RESULTS — Approximately 2,700 glucose values were obtained by each subject during 3 months. Linear regression analysis between the A1C and AG values provided the tightest cor-
Diabetic Medicine, 2018
Research: Epidemiology Interpretation of HbA 1c in primary care and potential influence of anaemi... more Research: Epidemiology Interpretation of HbA 1c in primary care and potential influence of anaemia and chronic kidney disease: an analysis from the Copenhagen Primary Care Laboratory (CopLab)
Diabetic Medicine, 2010
Aims Glycated haemoglobin (HbA 1c) has been proposed as an alternative to the oral glucose tolera... more Aims Glycated haemoglobin (HbA 1c) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods. Methods We assessed the prevalence of cardiovascular risk factors in individuals with undiagnosed diabetes according to the World Health Organization classification or by the newly proposed HbA 1c level ‡ 6.5% among 6258 participants of the Danish Inter99 study. Receiver operating curve analysis assessed the ability of fasting: 2-h plasma glucose and HbA 1c to distinguish between individuals at high and low risk of ischemic heart disease, predicted by the PRECARD program. Results Prevalence of undiagnosed diabetes was 4.1% [95% confidence interval (CI) 3.7-4.7%] by the current oral glucose tolerance test definition, whereas 6.6% (95% CI 6.0-7.2%) had diabetes by HbA 1c levels. HbA 1c-defined individuals were relatively older with higher proportions of men, smokers, lipid abnormalities and macro-albuminuria, but they were leaner and had lower blood pressure. HbA 1c was better than fasting-and 2-h plasma glucose at distinguishing between individuals of high and low predicted risk of ischaemic heart disease; however, the difference between HbA 1c and fasting-and 2-h plasma glucose was not statistically significant. Conclusions Compared with the current oral glucose tolerance test definition, more individuals were classified as having diabetes based on the HbA 1c criteria. This group had as unfavourable a risk profile as those identified by the oral glucose tolerance test.
Annals of Translational Medicine, 2021
Diabetic kidney disease is a frequent and costly complication to type 2 diabetes. After many year... more Diabetic kidney disease is a frequent and costly complication to type 2 diabetes. After many years with a lack of successful trials there are now significant developments that will change treatment, guidelines and future outcome. Since the last two decades blockade of the renin-angiotensin system (RAS) is standard treatment, but new antidiabetic treatments have shown potential for kidney protection. After cardiovascular outcome studies with glucagon-like peptide (GLP-1) receptor agonists it is evident that drugs like liraglutide, semaglutide and dulaglutide can reduce albuminuria levels and progression to macroalbuminuria. At present, a renal outcome trial with semaglutide is ongoing which will provide more evidence on the drug class in the future. The sodium glucose co-transporter 2 (SGLT2) inhibitor class has also demonstrated effects beyond glucose-lowering, as the drugs can reduce blood pressure, albuminuria and loss of renal function. In the first renal outcome study the SGLT2 inhibitor canagliflozin was found to reduce the risk of hard renal outcome with 30%. SGLT2 inhibition is now recommended in type 2 diabetes with chronic kidney disease. Renal outcome studies testing additional SGLT2 inhibitors and the GLP-1 receptor agonist semaglutide will report in the coming future potentially providing more and much needed options for treatment.
Diabetologia, 2010
Aims Increased glucose excursions and postprandial hyperglycaemia have been suggested as unique r... more Aims Increased glucose excursions and postprandial hyperglycaemia have been suggested as unique risk factors for cardiovascular disease (CVD) and mortality in patients with diabetes mellitus. Much of the evidence is based on a single 2 h glucose value after oral glucose tolerance testing in epidemiological studies. We examined the association between various indices of glycaemia measured during everyday activities and metabolic CVD risk factors in the A1C-Derived Average Glucose (ADAG) study. Methods Participants (268 with type 1 diabetes, 159 with type 2 diabetes) completed 16 weeks of intensive continuous glucose monitoring (CGM) and self-monitoring of blood glucose (SMBG). From these data, common indices of postprandial glycaemia, overall hyperglycaemia, glucose variability and HbA 1c were derived. The associations between glycaemic indices and known CVD risk factors (lipids, high-sensitivity C-reactive protein and blood pressure) were explored in linear regression models. Results For both diabetes types, the overall strongest associations with CVD risk factors were seen for the measures of average glycaemia (mean blood glucose and HbA 1c). Associations between self-monitored postprandial and fasting glucose and CVD risk factors were weaker, but significant. Measurements of blood glucose variability showed non-significant associations. Overall, calculations based on CGM were not more informative than those based on frequent SMBG. Conclusions/interpretation Mean glycaemia and HbA 1c show consistent and stronger associations with CVD risk factors than fasting glucose or postprandial glucose levels or measures of glucose variability in patients with diabetes. Keywords ADAG study. CVD risk. Glucose monitoring. Glucose variability. HbA 1c. Postprandial glycaemia. z score Abbreviations ADAG A1C-Derived Average Glucose study BG Blood glucose CGM Continuous glucose monitoring The Electronic supplementary material (ESM) contains a list of members of the ADAG Study Group Electronic supplementary material The online version of this article
Nephrology Dialysis Transplantation, 2018
Diabetologia, 2010
Aims/hypothesis Real-life glycaemic profiles of healthy individuals are poorly studied. Our aim w... more Aims/hypothesis Real-life glycaemic profiles of healthy individuals are poorly studied. Our aim was to analyse to what extent individuals without diabetes exceed OGTT thresholds for impaired glucose tolerance (IGT) and diabetes. Methods In the A1C-Derived Average Glucose (ADAG) study, 80 participants without diabetes completed an intensive glucose monitoring period of 12 weeks. From these data, we calculated the average 24 h glucose exposure as time spent above different plasma glucose thresholds. We also derived indices of postprandial glucose levels, glucose variability and HbA 1c. Results We found that 93% of participants reached glucose concentrations above the IGT threshold of 7.8 mmol/l and spent a median of 26 min/day above this level during continuous glucose monitoring. Eight individuals (10%) spent more than 2 h in the IGT range. They had higher HbA 1c , fasting plasma glucose (FPG), age and BMI than those who did not. Seven participants (9%) reached glucose concentrations above 11.1 mmol/l during monitoring. Conclusions/interpretation Even though the non-diabetic individuals monitored in the ADAG study were selected on the basis of a very low level of baseline FPG, 10% of these spent a considerable amount of time at glucose levels considered to be 'prediabetic' or indicating IGT. This highlights the fact that exposure to moderately elevated glucose levels remains under-appreciated when individuals are classified on the basis of isolated glucose measurements. Keywords Continuous glucose monitoring. Glucose monitoring. Glycaemia in healthy individuals. Non-diabetic glucose exposure. Normoglycaemia Abbreviations ADAG A1C-Derived Average Glucose CGM Continuous interstitial glucose monitoring FPG Fasting plasma glucose IGT Impaired glucose tolerance IQR Interquartile range Electronic supplementary material The online version of this article