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使用连续血糖监测评估体重对1型糖尿病患者血糖指数的影响。

Effect of Body Weight on Glycaemic Indices in People with Type 1 Diabetes Using Continuous Glucose Monitoring.

作者信息

Christou Maria A, Christou Panagiota A, Katsarou Daphne N, Georga Eleni I, Kyriakopoulos Christos, Markozannes Georgios, Christou Georgios A, Fotiadis Dimitrios I, Tigas Stelios

机构信息

Department of Endocrinology, University Hospital of Ioannina, 45500 Ioannina, Greece.

Department of Hygiene and Epidemiology, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

出版信息

J Clin Med. 2024 Sep 7;13(17):5303. doi: 10.3390/jcm13175303.

Abstract

: Obesity and overweight have become increasingly prevalent in different populations of people with type 1 diabetes (PwT1D). This study aimed to assess the effect of body weight on glycaemic indices in PwT1D. : Adult PwT1D using continuous glucose monitoring (CGM) and followed up at a regional academic diabetes centre were included. Body weight, body mass index (BMI), waist circumference, glycated haemoglobin (HbA1c), and standard CGM glycaemic indices were recorded. Glycaemic indices were compared according to BMI, and correlation and linear regression analysis were performed to estimate the association between measures of adiposity and glycaemic indices. : A total of 73 PwT1D were included (48% normal weight, 33% overweight, and 19% obese). HbA1c was 7.2% (5.6-10), glucose management indicator (GMI) 6.9% (5.7-8.9), coefficient of variation (CV) for glucose 39.5% ± 6.4, mean glucose 148 (101-235) mg/dL, TIR (time in range, glucose 70-180 mg/dL) 66% (25-94), TBR (time below range, 54-69 mg/dL) 4% (0-16), TBR (<54 mg/dL) 1% (0-11), TAR (time above range, 181-250 mg/dL) 20% ± 7, and TAR (>250 mg/dL) 6% (0-40). Glycaemic indices and achievement (%) of optimal glycaemic targets were similar between normal weight, overweight, and obese patients. BMI was associated negatively with GMI, mean glucose, TAR, and TAR and positively with TIR; waist circumference was negatively associated with TAR. : CGM-derived glycaemic indices were similar in overweight/obese and normal weight PwT1D. Body weight and BMI were positively associated with better glycaemic control. PwT1D should receive appropriate ongoing support to achieve optimal glycaemic targets whilst maintaining a healthy body weight.

摘要

肥胖和超重在1型糖尿病患者(PwT1D)的不同人群中日益普遍。本研究旨在评估体重对PwT1D患者血糖指标的影响。

纳入在区域学术糖尿病中心接受连续血糖监测(CGM)并进行随访的成年PwT1D患者。记录体重、体重指数(BMI)、腰围、糖化血红蛋白(HbA1c)和标准CGM血糖指标。根据BMI比较血糖指标,并进行相关性和线性回归分析,以评估肥胖指标与血糖指标之间的关联。

共纳入73例PwT1D患者(48%体重正常,33%超重,19%肥胖)。HbA1c为7.2%(5.6 - 10),血糖管理指标(GMI)为6.9%(5.7 - 8.9),血糖变异系数(CV)为39.5%±6.4,平均血糖为148(101 - 235)mg/dL,血糖在目标范围内时间(TIR,血糖70 - 180 mg/dL)为66%(25 - 94),血糖低于目标范围时间(TBR,54 - 69 mg/dL)为4%(0 - 16),血糖低于54 mg/dL时间(TBR,<54 mg/dL)为1%(0 - 11),血糖高于目标范围时间(TAR,181 - 250 mg/dL)为20%±7,血糖高于250 mg/dL时间(TAR,>250 mg/dL)为6%(0 - 40)。体重正常、超重和肥胖患者的血糖指标及最佳血糖目标达成率(%)相似。BMI与GMI、平均血糖、TAR和TAR呈负相关,与TIR呈正相关;腰围与TAR呈负相关。

基于CGM的血糖指标在超重/肥胖和体重正常的PwT1D患者中相似。体重和BMI与更好的血糖控制呈正相关。PwT1D患者应持续获得适当支持,以在维持健康体重的同时实现最佳血糖目标。

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