Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Department of Endocrinology, Diabetes and Metabolism, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Diabet Med. 2022 Aug;39(8):e14882. doi: 10.1111/dme.14882. Epub 2022 May 23.
The effectiveness of continuous glucose monitoring (CGM) in maintaining glycaemic control in type 1 diabetes mellitus and type 2 diabetes mellitus has been well demonstrated. However, the degree of glycaemic variability (GV) in people with type 3c diabetes mellitus has not been fully explored using CGM. This study aims to evaluate GV in type 3c diabetes mellitus participants and compare it to type 1 diabetes mellitus and type 2 diabetes mellitus.
Participants were grouped according to type of diabetes. GV, defined as percentage coefficient of variation (%CV), and other glycaemic indices were obtained using CGM (FreeStyle Libre, Abbott, Australia) from 82 participants across all three cohorts over a 14-day period. Comparison of baseline characteristics and GV were performed across all groups. Correlation of GV with C-peptide values, and whether pancreatic supplementation had an effect on GV were also assessed in the type 3c diabetes mellitus cohort.
GV of type 3c diabetes mellitus participants was within the recommended target of less than %CV 36% (p = 0.004). Type 3c diabetes mellitus participants had the lowest GV among the three groups (p = 0.001). There was a trend for lower C-peptide levels to be associated with higher GV in type 3c diabetes mellitus participants (p = 0.22). Pancreatic enzyme supplementation in type 3c diabetes mellitus participants did not have an effect on GV (p = 0.664).
Although type 3c diabetes mellitus participants were the least variable, they had the highest mean glucose levels and estimated HbA , which suggests that the concept of 'brittle' diabetes in type 3c diabetes mellitus is not supported by the results of CGM in this study and may be leading to poorer glycaemic control.
连续血糖监测（CGM）在 1 型和 2 型糖尿病中维持血糖控制的有效性已得到充分证实。然而，使用 CGM 尚未充分探索 3c 型糖尿病患者的血糖变异性（GV）程度。本研究旨在评估 3c 型糖尿病患者的 GV，并将其与 1 型和 2 型糖尿病进行比较。
根据糖尿病类型将参与者分组。在 14 天的时间内，使用 CGM（来自 Abbott 的 FreeStyle Libre，澳大利亚）从三个队列中的 82 名参与者中获取 GV 和其他血糖指数，定义为变异系数的百分比（%CV）。比较所有组的基线特征和 GV。还在 3c 型糖尿病队列中评估了 GV 与 C 肽值的相关性，以及胰腺补充是否对 GV 有影响。
3c 型糖尿病患者的 GV 在低于推荐目标的%CV 36%范围内（p=0.004）。3c 型糖尿病患者的 GV 在三组中最低（p=0.001）。3c 型糖尿病患者的 C 肽水平较低与 GV 较高呈趋势相关（p=0.22）。在 3c 型糖尿病患者中添加胰腺酶补充剂对 GV 没有影响（p=0.664）。
尽管 3c 型糖尿病患者的变异性最小，但他们的平均血糖水平和估计的 HbA 最高，这表明 CGM 结果不支持 3c 型糖尿病中“脆性”糖尿病的概念，并且可能导致血糖控制较差。
