1型糖尿病患者的胰岛素抵抗和CGM衍生的参数:它们是否相关?
Isabel Clinck1, Jonathan Mertens1,2, Kristien Wouters3
1Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, 2650 Edegem, Belgium.
The Journal of clinical endocrinology and metabolism
|January 10, 2024
概括
1型糖尿病 (T1D) 中的胰岛素抵抗 (IR) 与较差的连续血糖监测 (CGM) 结果有关. 较高的IR,以估计的葡萄糖处置率 (eGDR) 衡量,与CGM上超过范围的时间和更短的范围时间相关联.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 糖尿病管理 糖尿病管理
背景情况:
- 胰岛素抵抗 (IR) 是1型糖尿病 (T1D) 管理中的一个日益关注的问题.
- 了解IR和血糖控制之间的联系对于改善患者的治疗结果至关重要.
研究的目的:
- 在T1D患者中调查IR和持续血糖监测 (CGM) 衍生的血糖参数之间的关联.
- 确定CGM指标如范围内的时间 (TIR),范围以上的时间 (TAR),范围以下的时间 (TBR) 和血糖变异性 (CV) 是否与IR相关.
主要方法:
- 使用估计的葡萄糖处置率 (eGDR) 和高胰岛素-高血糖 (HEC) 来量化IR的两个数据库的回顾性分析.
- 在28天的时间内,分析了CGM数据,包括TIR,TAR,TBR和CV.
主要成果:
- 在287名受试者中,较高的IR (较低的eGDR) 与 TAR (39%对33%,P = .043) 的增加有关.
- 后勤回归显示,更高的eGDR与更高的TIR相关 (OR 1.251,P < .001),更低的TAR (OR 1.281,P < .001),以及更高的TBR (OR 0.893,P = .039).
- 在48名参与者中,CGM指标和HEC确定的葡萄糖处置率 (M值) 之间没有发现显著的关联.
结论:
- 在T1D患者中,eGDR测量的IR与不太有利的CGM配置文件有关.
- 这些发现强调了使用CGM数据评估T1D患者的IR的重要性.
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