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与 1 型糖尿病和成人隐匿性自身免疫性糖尿病(LADA)患者队列中血糖风险指数相关的因素。

Factors associated with Glycemia Risk Index in a cohort of patients with type 1 Diabetes Mellitus and Latent Autoimmune Diabetes In Adults (LADA).

机构信息

Endocrinology and Nutrition Department, University Hospital of Guadalajara, Guadalajara, Spain.

Instituto de Investigación Sanitaria de Castilla la Mancha (IDISCAM), Guadalajara, Spain.

出版信息

Endocrine. 2024 Nov;86(2):574-583. doi: 10.1007/s12020-024-03901-5. Epub 2024 Jun 6.

Abstract

OBJECTIVE

To analyze the degree of control based on classical glucometric parameters and Glycemia Risk Index (GRI) in real-life conditions in a cohort of patients with type 1 Diabetes Mellitus (DM) and Latent Autoimmune Diabetes in Adults (LADA) and to assess the factors that are associated with GRI.

PATIENTS AND METHODS

Cross-sectional study. 447 adult patients with type 1 DM and LADA users of Intermittent Continuous Glucose Monitoring (iCGM) with an adherence ≥ 70% were included. GRI was calculated with its Hypoglycemia (CHypo) and Hyperglycemia (CHyper) Components. Multivariate linear regression analysis was performed to evaluate the factors associated with GRI.

RESULTS

Mean age 44.6 years (SD 13.7); 57.7% men; 83.9% type 1 DM; 16.1% LADA; time of evolution 20.6 years (SD 12.3). In patients with type 1 DM vs. LADA, differences were observed in relation to age [-11.1 years (SD 1.7)], age of onset [-21.9 years (DE 1.5)], time of evolution [11.7 years (DE 1.5)], treatment modality (p < 0.001), Time in Range (TIR) [-6.3% (SD 2.2)], Time Below Range (TBR) [1.9% (SD 0.6)], TBR level 1 (TBR1) [1.4% (SD 0.5)], Time Above Range (TAR) level 2 (TAR2) [4.7% (SD 1.3)], Coefficient of Variation (CV) [4.6% (SD 0.9)], GRI [11.3% (SD 2.8)], CHypo [1.3% (SD 0.5)] and CHyper [4.8% (SD 1.7)]. The variables that were independently associated with GRI were TIR (β = -1.34; CI 95% -1.43 to -1.25; p < 0.001), Glucose Management Indicator (GMI) (β = -5.82; CI 95% -7.59 to -4.05; p < 0.001), CV (β = 0.67; CI 95% 0.57 to 0.77; p < 0.001) and adherence to sensor usage (β = -0.16; CI 95% -1.27 to -0.06; p < 0.002).

CONCLUSIONS

LADA present better control according to some glucometric parameters and a low GRI. However, the type of DM is not a factor that is independently associated with GRI.

摘要

目的

分析基于经典血糖参数和血糖风险指数(GRI)在 1 型糖尿病(T1DM)和成人隐匿性自身免疫性糖尿病(LADA)患者队列中的真实条件下的控制程度,并评估与 GRI 相关的因素。

方法

这是一项横断面研究。纳入了 447 名使用间歇性连续血糖监测(iCGM)且依从性≥70%的成年 T1DM 和 LADA 患者。用低血糖(CHypo)和高血糖(CHyper)成分计算 GRI。采用多元线性回归分析评估与 GRI 相关的因素。

结果

患者平均年龄 44.6 岁(SD 13.7);57.7%为男性;83.9%为 T1DM;16.1%为 LADA;病程 20.6 年(SD 12.3)。与 LADA 相比,T1DM 患者在年龄[-11.1 岁(SD 1.7)]、发病年龄[-21.9 岁(DE 1.5)]、病程[11.7 年(DE 1.5)]、治疗方式(p<0.001)、血糖控制时间(TIR)[-6.3%(SD 2.2)]、血糖控制时间以下(TBR)[1.9%(SD 0.6)]、TBR 水平 1(TBR1)[1.4%(SD 0.5)]、TBR 水平 2(TAR2)[4.7%(SD 1.3)]、变异系数(CV)[4.6%(SD 0.9)]、GRI[11.3%(SD 2.8)]、CHypo[1.3%(SD 0.5)]和 CHyper[4.8%(SD 1.7)]方面存在差异。与 GRI 独立相关的变量是 TIR(β=-1.34;95%CI -1.43 至-1.25;p<0.001)、血糖管理指标(GMI)(β=-5.82;95%CI -7.59 至-4.05;p<0.001)、CV(β=0.67;95%CI 0.57 至 0.77;p<0.001)和传感器使用依从性(β=-0.16;95%CI -1.27 至-0.06;p<0.002)。

结论

LADA 患者根据一些血糖参数表现出更好的控制,且 GRI 较低。然而,糖尿病类型并不是与 GRI 独立相关的因素。

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