Comparison of Waves and Energies between the 3-Hours Versus 24-Hours of Glucose Fluctuation using 3+ Years of Continuous Glucose Monitoring Sensor Device Collected Data Based on GH-Method: Math-Physical Medicine (No. 457)

Abstract

Gerald C Hsu

Since 2017, the author utilized his collected data of finger pierced glucoses 4x per day, along with the data of 10 metabolism index (MI) categories including 4 medical conditions and 6 lifestyle details over a 9.5-year period, from 2012 to 2021, to estimate his risk probabilities of having diabetic complications. They include macro-vascular and micro-vascular diseases such as cardiovascular disease, stroke, diabetic kidney disease, diabetic retinopathy, foot ulcer, Alzheimer’s disease, and certain cancers. In addition to the mean value of glucoses, namely the average glucose such as HbA1C, the actual glucose excursion or glucose fluctuation (GF) has noticeable influences on these diabetic complications. Starting from 5/5/2018, along with the finger glucoses, he collected 96 data of glucose values per day for 1,120 days using a continuous glucose monitoring (CGM) sensor device for a total of 107,520 glucose data. Thus far, he has accumulated 3+ years of sensor glucose data; therefore, he would like to enhance his medical research work by using them. Especially with 96 glucose data collected per day, he is now able to easily study the phenomenon of glucose excursion, glucose wave vibration, or glucose data oscillation. The medical community has used the term “glycemic variability (GV)” to describe the glucose excursion which involves several defined GV equations with some inconclusive findings. The author believes that the word “variability” could mean many things; therefore, he decided to apply the same basic concept of glucose excursion or GF without using the other defined GV equations in order to deeply understand and precisely describe the basic biophysical phenomenon of “glucose excursion”. The author has been utilizing glucose fluctuation known as “Daily GF or 24-hour GF” over a 24-hour period in his research work each day. The definition of GF is the maximum glucose (usually around 60-minutes after a meal) minus the minimum glucose (usually around 3am to 4am during sleep) within 24-hours or another selected time period. Recently, he noticed the extremely high and extremely low glucoses frequently occurring within a shorter duration of 3 hours. Therefore, he has inserted a new algorithm of computation into his software program to dynamically calculate the difference between the maximum glucose and the minimum glucose within the moving duration of 3 hours, at15-minute increments throughout the day. By the end of a day, the largest number of GF, which is defined as 3-hour GF, is selected and stored on the cloud server. Furthermore, to obtain a better view of the glucose waveform shape’s similarity, he utilizes the 90-days moving average of daily glucose which is named as eAG, along with the 24-hour GF, and daily 3-hour GF to serve as the basis of his analysis. Many research publications have covered the importance and impact of GV or GF on diabetic macro-vascular and microvascular complications (References 16 and 17). In those publications, it has defined and also “qualitatively proven” that GF does impact the macro-vascular system, including the heart and brain, and micro-vascular system such as kidneys, feet, eyes, nerves, etc. This article offers some quantitative proof of GF impact on the risk of having diabetic complications. It also investigates the insignificant difference between 24-hour daily GF and 3-hour GF.

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