Insulin Resistance and CGM-Derived Parameters in People With Type 1 Diabetes: Are They Associated?

IF 5 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Journal of Clinical Endocrinology & Metabolism Pub Date : 2024-10-15 DOI:10.1210/clinem/dgae015

Isabel Clinck, Jonathan Mertens, Kristien Wouters, Eveline Dirinck, Christophe De Block

{"title":"Insulin Resistance and CGM-Derived Parameters in People With Type 1 Diabetes: Are They Associated?","authors":"Isabel Clinck, Jonathan Mertens, Kristien Wouters, Eveline Dirinck, Christophe De Block","doi":"10.1210/clinem/dgae015","DOIUrl":null,"url":null,"abstract":"Background: Insulin resistance (IR) is increasingly more prevalent in people with type 1 diabetes (T1D).Objective: We investigated whether IR is associated with continuous glucose monitor (CGM)-derived parameters (glucometrics), such as time in range (TIR), time above range (TAR), time below range (TBR), and glycemic variability (CV).Methods: This is a retrospective analysis of 2 databases: IR was quantified according to the estimated glucose disposal rate (eGDR) (NCT04664036) and by performing a hyperinsulinemic-euglycemic clamp (HEC) (NCT04623320). All glucometrics were calculated over 28 days.Results: A total of 287 subjects were included. Mean age was 46 ± 17 years, 55% were male, TIR was 57% ± 14%, and eGDR was 7.6 (5.6-9.3) mg/kg/min. The tertile of people with the lowest eGDR (highest level of IR) had a higher TAR compared to the tertile with the highest eGDR (39% ± 15% vs 33% ± 14%, P = .043). Using logistic regression, a higher eGDR was associated with a higher chance to fall in a higher TIR-tertile (odds ratio [OR] 1.251, P < .001), a lower TAR-tertile (OR 1.281, P < .001), and a higher TBR-tertile (OR 0.893, P = .039), adjusted for age, sex, diabetes duration, smoking status, and alcohol intake. In the 48 people undergoing a HEC, no significant association between glucometrics and the HEC-determined glucose disposal rate (M-value) was observed.Conclusion: In people with T1D, an association between IR, measured by eGDR, and worse CGM profiles was observed.","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":null,"pages":null},"PeriodicalIF":5.0000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Endocrinology & Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1210/clinem/dgae015","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Insulin resistance (IR) is increasingly more prevalent in people with type 1 diabetes (T1D).

Objective: We investigated whether IR is associated with continuous glucose monitor (CGM)-derived parameters (glucometrics), such as time in range (TIR), time above range (TAR), time below range (TBR), and glycemic variability (CV).

Methods: This is a retrospective analysis of 2 databases: IR was quantified according to the estimated glucose disposal rate (eGDR) (NCT04664036) and by performing a hyperinsulinemic-euglycemic clamp (HEC) (NCT04623320). All glucometrics were calculated over 28 days.

Results: A total of 287 subjects were included. Mean age was 46 ± 17 years, 55% were male, TIR was 57% ± 14%, and eGDR was 7.6 (5.6-9.3) mg/kg/min. The tertile of people with the lowest eGDR (highest level of IR) had a higher TAR compared to the tertile with the highest eGDR (39% ± 15% vs 33% ± 14%, P = .043). Using logistic regression, a higher eGDR was associated with a higher chance to fall in a higher TIR-tertile (odds ratio [OR] 1.251, P < .001), a lower TAR-tertile (OR 1.281, P < .001), and a higher TBR-tertile (OR 0.893, P = .039), adjusted for age, sex, diabetes duration, smoking status, and alcohol intake. In the 48 people undergoing a HEC, no significant association between glucometrics and the HEC-determined glucose disposal rate (M-value) was observed.

Conclusion: In people with T1D, an association between IR, measured by eGDR, and worse CGM profiles was observed.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

1 型糖尿病患者的胰岛素抵抗和 CGM 衍生参数：它们有关联吗？

背景：胰岛素抵抗（IR）在 1 型糖尿病（T1D）患者中越来越普遍。我们研究了胰岛素抵抗是否与连续血糖监测仪（CGM）得出的参数（血糖测量）有关，如在量程内的时间（TIR）、高于量程的时间（TAR）、低于量程的时间（TBR）和血糖变异性（CV）：这是一项对两个数据库的回顾性分析：方法：这是对两个数据库的回顾性分析：根据估计的葡萄糖排出率（eGDR）（NCT04664036）和高胰岛素血症-高血糖钳夹（HEC）（NCT04623320）对IR进行量化。所有血糖指标均按 28 天计算：结果：共纳入 287 名受试者。平均年龄为 46 ± 17 岁，55% 为男性，TIR 为 57 ± 14%，eGDR 为 7.6 (5.6 - 9.3) mg/kg min。与 eGDR 最高的三等分人群相比，eGDR 最低的三等分人群（IR 水平最高）的 TAR 较高（39 ± 15% 对 33 ± 14，p = 0.043）。通过逻辑回归，eGDR 越高，TIR-越高的几率也越大（OR 1.251，p 结论：TIR-越高，TAR-越大：在 T1D 患者中，通过 eGDR 测量的 IR 与较差的 CGM 资料之间存在关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Clinical Endocrinology & Metabolism 医学-内分泌学与代谢

CiteScore

11.40

自引率

5.20%

发文量

673

审稿时长

1 months

期刊介绍： The Journal of Clinical Endocrinology & Metabolism is the world"s leading peer-reviewed journal for endocrine clinical research and cutting edge clinical practice reviews. Each issue provides the latest in-depth coverage of new developments enhancing our understanding, diagnosis and treatment of endocrine and metabolic disorders. Regular features of special interest to endocrine consultants include clinical trials, clinical reviews, clinical practice guidelines, case seminars, and controversies in clinical endocrinology, as well as original reports of the most important advances in patient-oriented endocrine and metabolic research. According to the latest Thomson Reuters Journal Citation Report, JCE&M articles were cited 64,185 times in 2008.