S Daenen

Publications (3)4.82 Total impact

• Article: Peak-time determination of post-meal glucose excursions in insulin-treated diabetic patients.

  S Daenen, A Sola-Gazagnes, J M'Bemba, C Dorange-Breillard, F Defer, F Elgrably, E Larger, G Slama
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  ABSTRACT: This study aimed to determine the optimal time to measure peak blood glucose values to find the best approach for self-monitoring blood glucose after a meal. For this retrospective analysis, 69 ambulatory continuous glucose-monitoring system (CGMS) profiles were obtained from 75 consecutive insulin-treated patients with diabetes. The parameters measured were the peak post-meal blood glucose values, peak time, and rates of increase and decrease to and from the zenith of the resulting curves. The mean peak time after breakfast was 72+/-23 min, which was reached in less than 90 min in 80% of the patients. The apparent glucose rate of increase from pre-meal to the maximum postprandial value was 1.23+/-0.76 mg/dL/min, while the glucose rate of decrease was 0.82+/-0.70 mg/dL/min. Peak time correlated with the amplitude of postprandial excursions, but not with the peak glucose value. Also, peak times were similar after breakfast, lunch and dinner, and in type 1 and type 2 diabetic patients. To best assess peak postprandial glucose levels, the optimal time for blood glucose monitoring is about 1h and 15 min after the start of the meal, albeit with wide interpatient variability. Nevertheless, 80% of post-meal blood glucose peaks were observed at less than 90 min after the start of the meal.
  Diabetes & Metabolism 03/2010; 36(2):165-9. · 2.41 Impact Factor
• Article: Prevalence and predictive factors of sleep apnoea syndrome in type 2 diabetic patients.

  J-P Laaban, S Daenen, D Léger, S Pascal, V Bayon, G Slama, F Elgrably
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  ABSTRACT: This study aimed to assess the prevalence and characteristics of sleep apnoea syndrome (SAS) in patients hospitalized for poorly controlled type 2 diabetes. An overnight ventilatory polygraphic study was systematically performed in 303 consecutive patients. Overall, 34% of these patients had mild SAS, as defined by a respiratory disturbance index (RDI) of 5-15; 19% had moderate SAS (RDI: 16-29) and 10% had severe SAS (RDI>or=30). The SAS was obstructive in 99% of the apnoeic patients. The percentage of patients with excessive daytime sleepiness (Epworth sleepiness scale>10), fatigue or nocturia did not significantly differ among patients with severe, moderate or mild SAS versus non-apnoeic patients. The percentage of patients who snored was significantly higher in patients with severe or moderate SAS versus non-apnoeic patients. HbA(1c), duration of diabetes and the prevalences of microalbuminuria, retinopathy and peripheral neuropathy did not significantly differ among patients with severe, moderate or mild SAS versus non-apnoeic patients. However, patients with severe or moderate SAS had significantly higher values for body mass index, waist circumference and neck circumference than non-apnoeic patients. In type 2 diabetic patients with poor diabetic control, obstructive SAS is highly prevalent and related to abdominal obesity, and should be systematically screened for, as it cannot be predicted by the clinical data.
  Diabetes & Metabolism 09/2009; 35(5):372-7. · 2.41 Impact Factor
• Article: Peak-time determination of post-meal glucose excursions in insulin-treated diabetic patients

  S. Daenen, A. Sola-Gazagnes, J. M’Bemba, C. Dorange-Breillard, F. Defer, F. Elgrably, É. Larger, G. Slama
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  ABSTRACT: ObjectiveThis study aimed to determine the optimal time to measure peak blood glucose values to find the best approach for self-monitoring blood glucose after a meal.Design and methodsFor this retrospective analysis, 69 ambulatory continuous glucose-monitoring system (CGMS) profiles were obtained from 75 consecutive insulin-treated patients with diabetes. The parameters measured were the peak post-meal blood glucose values, peak time, and rates of increase and decrease to and from the zenith of the resulting curves.ResultsThe mean peak time after breakfast was 72 ± 23 min, which was reached in less than 90 min in 80% of the patients. The apparent glucose rate of increase from pre-meal to the maximum postprandial value was 1.23 ± 0.76 mg/dL/min, while the glucose rate of decrease was 0.82 ± 0.70 mg/dL/min. Peak time correlated with the amplitude of postprandial excursions, but not with the peak glucose value. Also, peak times were similar after breakfast, lunch and dinner, and in type 1 and type 2 diabetic patients.ConclusionTo best assess peak postprandial glucose levels, the optimal time for blood glucose monitoring is about 1 h and 15 min after the start of the meal, albeit with wide interpatient variability. Nevertheless, 80% of post-meal blood glucose peaks were observed at less than 90 min after the start of the meal.RésuméButDéterminer le moment du pic glycémique postprandial pour déterminer le meilleur moment pour l’autosurveillance postprandiale.MéthodesNous avons analysé de façon rétrospective 69 holters glycémiques (CGMS) consécutifs obtenus en ambulatoire chez 75 patients diabétiques insulinotraités. Nous avons analysé la valeur du pic glycémique postprandial, son moment de survenue après le début du repas, la courbe de croissance puis de décroissance de la glycémie après le repas.RésultatsLe pic glycémique postprandial est survenu en moyenne à la 72 ± 23e minutes après le petit déjeuner. Ce pic est survenu pour 80 % des patients avant la 90e minute. La vitesse de croissance entre le début du repas et le pic était de 1,23 ± 0,76 mg/dL par minute. La vitesse de décroissance était de 0,82 ± 0,70 mg dL par minute. Le moment de survenue du pic était en corrélation avec l’amplitude du pic postprandial, mais non avec la valeur du pic. Le moment de survenue du pic était similaire pour le petit déjeuner, le déjeuner et le dîner chez les patients diabétiques de type 1 ou 2 insulinotraités.ConclusionLe moment de survenue du pic glycémique postprandial est en moyenne de 1 h 15 minutes après le début du repas avec cependant une large variabilité inter-sujets. Cependant, 80 % des patients ont leur pic glycémique postprandial avant la 90e minute après le repas.
  Diabetes & Metabolism.