来自五项研究的持续血糖监测指标确定了患有1型糖尿病发展风险的参与者
Peter Calhoun1, Charles Spanbauer2, Andrea K Steck3
1Jaeb Center for Health Research, Tampa, FL, USA. pcalhoun@jaeb.org.
Diabetologia
|February 11, 2025
概括
连续血糖监测 (CGM) 度量,结合其他因素,可以准确预测1型糖尿病的进展. 这有助于识别患有疾病高风险的个体,有助于早期干预策略.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 1型糖尿病 (T1D) 的诊断依赖于识别自身抗体和临床症状.
- 预测具有小岛自身抗体 (AAb) 的高危个体的T1D进展对于及时干预至关重要.
- 持续血糖监测 (CGM) 提供了详细的血糖洞察力,但其对T1D诊断的预测能力需要进一步评估.
研究的目的:
- 评估CGM指标在预测3期T1D诊断中的有效性,在具有阳性岛屿自身抗体 (AAb) 的个体中.
- 为了比较单独使用CGM指标,单独使用参与者特征和组合模型的预测性能.
主要方法:
- 利用了208名参与者在五项研究 (ASK,BDR,DAISY,DIPP,TrialNet预防途径) 中≥1个阳性AAb的基线CGM数据.
- 随访时间的中位数为2.6年.
- 我们比较了三个预测模型:仅特征,仅CGM指标,以及整合两者的完整模型.
主要成果:
- 完整模型的预测性能优于特征模型 (C=0.69) 和CGM模型 (C=0.68) 的预测性能 (C统计=0.74).
- 关键预测因素包括与葡萄糖超过7.8 mmol/l的时间,HbA1c,T1D家族史和IA-2 AAb阳性.
- 风险分层确定了低 (5%),中等 (13%),高 (48%) 风险组在2年内发展症状T1D的明显概率.
结论:
- 当CGM指标与临床特征相结合时,可显著提高第三阶段T1D诊断的预测.
- 这种综合方法有助于分类T1D进展的个体风险.
- CGM数据可以完善风险评估,并为T1D预防试验的资格提供信息.
相关概念视频
Diabetes Mellitus: Type 2 and Gestational
2.1K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.1K
Diabetes: Symptoms, Diagnosis, and Complications
499
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
499
Diabetes Mellitus: Overview and Type I Subtype
2.4K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.4K
Pathophysiology of Diabetes
848
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
848
Carbohydrate Metabolism
10.7K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
10.7K
Hypoglycemia and Glucagon
149
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
149


