case_images: PMC10837046_01
case_images: Examples of glucose profiles in both cases. Examples of glucose profiles on isCGM of cases 1 and 2 are shown. Arrows are the typical timing, significantly increased or decreased glucose fluctuation.. isCGM - intermittently scanned continuous glucose monitoring; AGP - ambulatory glucose profile; CSII - continuous subcutaneous insulin infusion
case_images: cureus-0016-00000051607-i01.jpg
case_images: PMC10837046_02_cureus-0016-00000051607-i01.jpg
case_images: FIG1
case_images: Especially, unexpected hypoglycemia occurred mainly late at night and sometimes in the daytime due to increased physical activity while at work in a factory (Figure 1) with TAR, TIR, and TBR of 40%, 54%, and 6%, respectively (Table 1). First, we assessed the subjects' patterns of glucose trends before CSII initiation via isCGM (Figure 1). Concurrently, we discussed the glucose trends and adjusted the bolus insulin settings and basal insulin rate based on data from the cloud-platform-based system LibreView  (Figure 1). Though both cases showed hypoglycemia on the first day of CSII initiation, they showed relatively well-controlled glucose trends (Figure 1).
case_images: PMC10837046_02
case_images: Examples of glucose profiles in both cases. Examples of glucose profiles on isCGM of cases 1 and 2 are shown. Arrows are the typical timing, significantly increased or decreased glucose fluctuation.. isCGM - intermittently scanned continuous glucose monitoring; AGP - ambulatory glucose profile; CSII - continuous subcutaneous insulin infusion
case_images: cureus-0016-00000051607-i01.jpg
case_images: PMC10837046_02_cureus-0016-00000051607-i01.jpg
case_images: FIG1
case_images: Especially, unexpected hypoglycemia occurred mainly late at night and sometimes in the daytime due to increased physical activity while at work in a factory (Figure 1) with TAR, TIR, and TBR of 40%, 54%, and 6%, respectively (Table 1). First, we assessed the subjects' patterns of glucose trends before CSII initiation via isCGM (Figure 1). Concurrently, we discussed the glucose trends and adjusted the bolus insulin settings and basal insulin rate based on data from the cloud-platform-based system LibreView  (Figure 1). Though both cases showed hypoglycemia on the first day of CSII initiation, they showed relatively well-controlled glucose trends (Figure 1).
case_images: The telemedicine image with video-meeting tools sharing isCGM data and procedure. Desktop image of telemedicine in the present case. We confirmed the insulin pump procedure (left side) through a video meeting tool (Zoom Video Productions Inc, San Jose, CA) and glucose trends using LibreView  (Abbott Diabetes Care Inc., CA, USA), which is displayed on the right side. A video-cropped image is obtained at the time of exchanging insulin syringes.. isCGM - intermittently scanned continuous glucose monitoring
case_images: cureus-0016-00000051607-i02.jpg
case_images: PMC10837046_02_cureus-0016-00000051607-i02.jpg
case_images: FIG2
case_images: During the meeting, we observed the actual procedure of filling an insulin reservoir and inserting an infusion set (Figure 2), which was appropriate and safe.