Suresh Arjun, Kumar Bhargavi, Boopathy Sindhumalini, Thangavelu Saravanan
Department of General Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
Indian J Endocrinol Metab. 2024 Sep-Oct;28(5):522-528. doi: 10.4103/ijem.ijem_469_23. Epub 2024 Nov 8.
Diabetes mellitus is a global health burden, and India is regarded as the diabetes capital of the world. Glycaemic variability (GV) is an established risk factor for hypoglycaemia (plasma glucose concentration <70 mg/dL) and a notorious risk factor for diabetes complications. The primary aim of the study was to assess the correlation between the GV indices, HbA1c levels, and measures of hypoglycaemia in patients with type 2 DM (T2DM).
In this cross-sectional study, continuous glucose monitoring (CGM) was done for a period of 14 days in T2DM patients (n = 50). The GV indices were determined from the readings obtained from the CGM monitor. Spearman's rank correlation coefficient was used for correlation analyses. The area under the receiver operating characteristics (ROC) curve was used to assess the effectiveness of the various GV indices in predicting hypoglycaemia.
A total of 50 T2DM patients had a mean (SD) age of 61.84 ± 11.88 years. Among the GV indices, high blood glucose index (HBGI), average daily risk range (ADRR), and continuous overall net glycaemic action (CONGA) had a significantly positive correlation with HbA1c levels. Average episodes of nocturnal hypoglycaemia in 8 hours of night-time had a statistically significant negative correlation with the HbA1c levels (correlation coefficient: -0.301, = 0.034). In addition, low blood glucose index (LBGI) was found to be the best predictor for the risk of hypoglycaemia in 24 hours and nocturnal hypoglycaemia.
Various GV indices are associated with HbA1c levels and are better predictors of hypoglycaemia.
糖尿病是一项全球性的健康负担，印度被视为世界糖尿病之都。血糖变异性（GV）是低血糖（血浆葡萄糖浓度<70mg/dL）的既定风险因素，也是糖尿病并发症的一个臭名昭著的风险因素。本研究的主要目的是评估2型糖尿病（T2DM）患者的GV指数、糖化血红蛋白（HbA1c）水平与低血糖指标之间的相关性。
在这项横断面研究中，对50例T2DM患者进行了为期14天的持续葡萄糖监测（CGM）。根据CGM监测仪获得的读数确定GV指数。采用Spearman等级相关系数进行相关性分析。采用受试者工作特征（ROC）曲线下面积评估各种GV指数预测低血糖的有效性。
共有50例T2DM患者，平均（标准差）年龄为61.84±11.88岁。在GV指数中，高血糖指数（HBGI）、平均每日风险范围（ADRR）和连续总体净血糖作用（CONGA）与HbA1c水平呈显著正相关。夜间8小时的平均夜间低血糖发作次数与HbA1c水平呈统计学显著负相关（相关系数：-0.301，P = 0.034）。此外，低血糖指数（LBGI）被发现是24小时和夜间低血糖风险的最佳预测指标。
各种GV指数与HbA1c水平相关，并且是低血糖更好的预测指标。
