2型糖尿病患者连续血糖监测指标与糖化血红蛋白之间的关联。
Associations between continuous glucose monitoring-derived metrics and HbA1c in patients with type 2 diabetes mellitus.
作者信息
Kurozumi Akira, Okada Yosuke, Mita Tomoya, Wakasugi Satomi, Katakami Naoto, Yoshii Hidenori, Kanda Kazuko, Nishida Keiko, Mine Shinichiro, Tanaka Yoshiya, Gosho Masahiko, Shimomura Iichiro, Watada Hirotaka
机构信息
First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan; Clinical Research Center, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
出版信息
Diabetes Res Clin Pract. 2022 Apr;186:109836. doi: 10.1016/j.diabres.2022.109836. Epub 2022 Mar 18.
AIMS
The aim of this study was to define the relationship between time in range (TIR) and hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM).
METHODS
The glycemic profile of 999 Japanese patients was analyzed with FreeStyle Libre Pro Continuous Glucose Monitoring (FLP-CGM) while they continued their prescribed glucose-lowering medications. FLP-CGM data recorded over 8 consecutive days were analyzed.
RESULTS
The regression model for HbA1c on TIR was HbA1c = 9.4966-0.0309 × TIR. The predicted HbA1c level for TIR of 70% was 7.33% and is higher than reports subjecting mostly T1DM. The TIR corresponding to HbA1c 7.0% was 80.64%. The patients with low TIR tended to have long duration of diabetes, used high dose of daily insulin, high body mass index, high HbA1c, liver dysfunction and high triglyceride. Relatively higher percentages of patients of this group used sulfonylureas, glucagon like peptide-1 receptor agonists and insulin.
CONCLUSIONS
Our data showed predicted HbA1c corresponding to TIR is largely depends on study population, thus is not uniform. Our results provide new insights on the management of T2DM. However, caution should be exercised in extending the HbA1C-TIR relationship using FLP-CGM to any other sensors since there could be a risk of hypoglycemia in doing so.
目的
本研究旨在明确2型糖尿病（T2DM）患者血糖达标时间（TIR）与糖化血红蛋白（HbA1c）水平之间的关系。
方法
对999例日本患者在继续使用降糖处方药的同时，采用FreeStyle Libre Pro连续血糖监测（FLP-CGM）分析其血糖谱。分析连续8天记录的FLP-CGM数据。
结果
HbA1c关于TIR的回归模型为HbA1c = 9.4966 - 0.0309×TIR。TIR为70%时预测的HbA1c水平为7.33%，高于大多数1型糖尿病（T1DM）研究报告中的水平。HbA1c为7.0%时对应的TIR为80.64%。TIR较低的患者往往糖尿病病程较长、每日胰岛素用量高、体重指数高、HbA1c高、肝功能障碍及甘油三酯高。该组患者中使用磺脲类药物、胰高血糖素样肽-1受体激动剂和胰岛素的比例相对较高。
结论
我们的数据表明，对应于TIR的预测HbA1c很大程度上取决于研究人群，因此并不统一。我们的结果为T2DM的管理提供了新的见解。然而，在将FLP-CGM的HbA1C-TIR关系推广到任何其他传感器时应谨慎，因为这样做可能存在低血糖风险。
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