Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece.
School of Medicine, European University Cyprus, Nicosia, Cyprus.
J Diabetes Sci Technol. 2024 Mar;18(2):414-422. doi: 10.1177/19322968221123530. Epub 2022 Sep 13.
Comprehensive characteristics of the glycemic profile for prediabetes derived by continuous glucose monitoring (CGM) are unknown. We evaluate the difference of CGM profiles between individuals with prediabetes and normoglycemic individuals, including the response to oral glucose tolerance test (OGTT).
Individuals with prediabetes matched for age, sex, and BMI with normoglycemic individuals were instructed to use professional CGM for 1 week. OGTT was performed on the second day. The primary outcomes were percentages of glucose readings time below range (TBR): <54 or <70 mg/dL, time in range (TIR): 70 to 180 mg/dL, and time above range (TAR): >180 or >250 mg/dL. Area under the curve (AUC) was calculated following the OGTT. Glucose variability was depicted by coefficient of variation (CV), SD, and mean amplitude of glucose excursion (MAGE). Wilcoxon sign-ranked test, McNemar mid -test and linear regression models were employed.
In all, 36 participants (median age 51 years; median body mass index [BMI] = 26.4 kg/m) formed 18 matched pairs. Statistically significant differences were observed for 24-hour time in range (TIR; median 98.5% vs. 99.9%, = .013), time above range (TAR) >180 mg/dl (0.4% vs. 0%, = .0062), and 24-hour mean interstitial glucose (113.8 vs. 108.8 mg/dL, = .0038) between people with prediabetes compared to normoglycemic participants. Statistically significant differences favoring the normoglycemic group were found for glycemic variability indexes (median CV 15.2% vs. 11.9%, = .0156; median MAGE 44.3 vs. 33.3 mg/dL, = 0.0043). Following OGTT, the AUC was significantly lower in normoglycemic compared to the prediabetes group (median 18615.3 vs. 16370.0, = .0347 for total and 4666.5 vs. 2792.7, = .0429 for incremental 2-hour post OGTT).
Individuals with prediabetes have different glucose profiles compared to normoglycemic individuals. CGM might be helpful in individuals with borderline glucose values for a more accurate reclassification.
通过连续血糖监测（CGM）得出的糖尿病前期患者的血糖特征综合情况尚不清楚。我们评估了糖尿病前期患者与血糖正常者之间 CGM 谱的差异，包括对口服葡萄糖耐量试验（OGTT）的反应。
将年龄、性别和 BMI 与血糖正常者相匹配的糖尿病前期患者指导使用专业 CGM 一周。第二天进行 OGTT。主要结局指标是血糖读数时间低于以下范围的百分比（TBR）：<54 或<70mg/dL、时间在范围内（TIR）：70 至 180mg/dL 和时间超过范围（TAR）：>180 或>250mg/dL。根据 OGTT 计算曲线下面积（AUC）。葡萄糖变异性用变异系数（CV）、标准差和血糖波动幅度（MAGE）表示。采用 Wilcoxon 符号秩检验、McNemar 中检验和线性回归模型。
共有 36 名参与者（中位年龄 51 岁；中位体重指数[BMI] = 26.4kg/m）组成 18 对匹配组。糖尿病前期患者与血糖正常者相比，24 小时 TIR（中位数 98.5%比 99.9%， =.013）、TAR>180mg/dl（0.4%比 0%， =.0062）和 24 小时平均间质葡萄糖（113.8 比 108.8mg/dL， =.0038）存在统计学差异。与血糖正常组相比，糖尿病前期患者的血糖变异性指标（中位数 CV 15.2%比 11.9%， =.0156；中位数 MAGE 44.3 比 33.3mg/dL， =0.0043）存在统计学差异。OGTT 后，血糖正常组与糖尿病前期组的 AUC 明显较低（中位数 18615.3 比 16370.0， =.0347 为总 AUC，4666.5 比 2792.7， =.0429 为 2 小时增量 AUC）。
与血糖正常者相比，糖尿病前期患者的血糖谱存在差异。CGM 可能有助于对边缘血糖值的个体进行更准确的重新分类。
