1. Ambulatory glucose profile measurement- is it a practical tool for monitoring diabetes? 
Dr Adhya Mehta
Department of Medicine
Lady Hardinge Medical College & SSK Hospital, New Delhi.
Financial disclosure- nil
Conflict of interest- nil

2. Introduction A1c- avg of last 3 mths AGP (Ambulatory Glucose Profile)
new technology
automatically records glucose every 15 min x 14 d,
provides with
estimated A1c of preceding 14 days
episodes of hyperglycaemia
episodes of hypoglycaemia
Glycemic variability

3. Aim
To assess whether information obtained by AGP can be practically used in our set-up
Does it add to the information provided by laboratory-provided A1c values?

4. Methodology N = 50 T2DM ≥18 years of age
Diabetes Clinic of SSKH (LHMC), New Delhi.
Type of Study : Cross-sectional
A1c determined using Alere Afinion™ AS100 Analyzer using capillary blood glucose
Those with HbA1c <8%, were placed AGP using FreeStyle Libre Pro®.

5. Values of laboratory determined A1c were compared with that estimated by the AGP device.
Patients were divided into two groups on the basis of their A1c levels-
A1c <7% (controlled)
A1c between 7-8% (uncontrolled).
Average episodes of hyperglycaemia and hypoglycaemia were calculated for each group.

8. RESULTS

9. Results
Laboratory-determined A1c had a significant correlation with A1c estimated by AGP (r=0.617, p=0.0028).

10. Avg duration of hyperglycaemia episodes- 13.53± 9%
Controlled diabetes
Avg duration of hyperglycaemia episodes ± 9%
Avg duration of hypos were 8.13± 11.4%
Uncontrolled diabetes
Avg hypoglycaemia episodes were 3.34±5.84%
None of these hypoglycaemic events were picked up on SMPG measurements by the subjects

12. AGP graphs from four T2 patients with A1c = 7.6 to 7.7%

13. Conclusion Estimated A1c on AGP correlates well with laboratory A1c
However, importantly AGP provides additional information
Asymptomatic hypoglycaemic events in well-controlled and uncontrolled patients
hyperglycaemic events in well-controlled patients
Identify therapeutic time points of intervention

14. Study in JAPI Apr 2016 also re-enforces these points.