Projects, designs, and writings on health IT

2016-04-12

Fingerstick glucose

2:40 PM Posted by David Do, MD No comments
This is the start of a series where I will generate charts of de-identified data analysis, revealing some things we knew and some we did not about physiology. The queries that I run do not return any protected health information.

Fingerstick glucose

Fingerstick glucose can be measured with a handheld device with instantaneous results. They are regarded as less accurate than the gold standard laboratory glucose. Here I plotted fingerstick glucose measurements against laboratory glucose measurements that were done within 15 minutes of each other. Except for a few outliers, the reliability appears good.


The abundance of fingerstick measurements by hour of day reveals, as expected, peaks, at 7am, 11am, 4pm, and 9pm, before breakfast, lunch, dinner, and bedtime.


The average glucose measurement by hour of day reveals a diurnal trend that is influenced by the meals we eat.

Hypoglycemic events (glucose measurement under 60) are most common at 3am, 9am, 2pm, 6pm, and 10pm. This corresponds to 1-2 hours after meals. Is this perhaps from people eating less than expected?

Hyperglycemic events (glucose measurement over 300) tend to happen at the same post-meal times.

When I stratify the population by age, we can see that people over 40 tend to remain at a higher glucose level, even between meals. Over time, their area under the curve is significantly higher. I chose not to adjust for other factors like comorbid illness and weight, because in real life those things co-occur. Therefore, this does not evaluate age as an independent risk factor.

When I stratify the population by weight, we can see that there is minimal difference between patients over and under 80kg. The only significant difference is overnight at 2-4am, when the heavier group has a much higher level.
The trend continues when we stratify with a cutoff of 120kg.

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