Case Study. Patient Profile. Baseline Report - Daily Patterns. Insights

Transcription

1 Case Study Patient Profile Sex/Age: Male, elderly Disease diagnosis: Type 2 for the past 30 years, recurrent episodes of hunger HbA1c: 6.2% Diabetes medication profile: DPP-4 inhibitor 50 mg twice a day, 6 mg, metformin 1,000 mg twice a day Current glucose monitoring: Laboratory fasting blood glucose 102 mg/dl, post prandial blood glucose 140 mg/dl Rationale for sensor monitoring: To assess episodes of suspected hypoglycemia Baseline Report - Daily Patterns Insights 1. Are the readings within target range? With a laboratory HbA1c of 6.2%, many of the patient s glucose readings appear to be within target range. 2. What are the patterns of hypoglycemia? Episodes of hypoglycemia noted during noon, evening and early morning. 3. What is the shape of the median curve? The shape of the median curve shows the patient had a tendency of falling glucose levels after midnight, mid-day, and in the evening. 4. What is the width of the IQR? Width of the IQR shows that the glycemic variability is minimal. ID: IN-FSLP The case study is intended for medical information/education purposed only. It is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary. Information contained herein for distribution outside of the US ONLY. Local legal and regulatory approval is required to publish any content. ADC v1.0 06/ of 5

2 Actionable Insights Considerations Next Steps Target Range Most readings are within target range n/a Patterns of Hypoglycemia What might be contributing to delayed postprandial hypoglycemia? Conduct a medication recall to assess if he is taking the prescribed medications doses at the correct times. Why might he experience hypoglycemia overnight? Conduct a dietary recall to assess the adequacy and consistency of carbohydrate intake at all meals, especially at dinner or before bedtime. Shape of Median Curve Why is the median curve decreasing moderately after meals and overnight? Same as above Width of IQR Width of the IQR is minimal n/a 2 of 5

3 Baseline Report - Glucose Pattern Insights Insights 1. Where is the risk of hypoglycemia the greatest as indicated by the likelihood of low glucose assessment? Between 13:00 and 08: Where is the highest deviation from the median glucose goal indicating the need for greater clinical attention? There is minimal deviation from the median glucose goal throughout the entire 24 hour period reflected in the normal HbA1c level. 3. W here is the variability below the median greater than a level that would support achieving the median goal without potentially causing low blood glucose? Indications for variability below the median is moderate between 08:00 and 20:00. Changes to therapy that would potentially result in glucose lowering during this period should be cautiously considered. Modifications (as a result of report interpretation): Sulfonylurea was discontinued. 3 of 5

4 Subsequent Report - Daily Patterns 1. Are the readings within target range? The patient s glucose readings are within the selected target range. 2. What are the patterns of hypoglycemia? The risk of hypoglycemia reduced, although some episodes are still noted in the early mornings. 3. What is the shape of the median curve? The shape of the median curve shows no alarming trends of hypoglycemia. 4. What is the width of the IQR? Width of the IQR shows that the glycemic variability is minimal. 4 of 5

5 Subsequent Report - Glucose Pattern Insights 1. Where is the risk of hypoglycemia the greatest as indicated by the likelihood of low glucose assessment? There is still a moderate likelihood of low glucose 13:00-08:00 2. Where is the highest deviation from the median glucose goal indicating the need for greater clinical attention? There is minimal deviation from the median glucose goal through out the entire 24 hour period reflected in the normal A1c level, as noted in the baseline AGP assessment. 3. Where is the variability below the median greater than a level that would support achieving the median goal without potentially causing low blood glucose? Indications for variability below the median is moderate between 20:00 and 24:00. Changes to therapy that would potentially result in glucose lowering during this period should be cautiously considered. Modifications (as a result of report interpretation): Analysis of subsequent AGP confirmed that the cessation of sulfonylurea resulted in resolution of hypoglycaemic events and symptoms of hunger. 5 of 5