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通过持续葡萄糖监测(CGM)测量的血糖达标时间百分比与2型糖尿病老年人身体健康敏捷状况指标之间的关联:一项横断面研究。

The Association Between Time in Range %, Measured by Continuous Glucose Monitoring (CGM) and Physical Health Agility Status Indices Amongst Older People with T2D: A Cross-Sectional Study.

作者信息

Basson-Shleymovich Yamit, Yahalom-Peri Tal, Azmon Michal, Cukierman-Yaffe Tali

机构信息

Epidemiology Department, School of Public Health, Faculty of Health, Tel Aviv University, Tel Aviv 6997801, Israel.

Clalit Health Services, Blumental Physical Therapy Clinic, Bnei-Brak 5126722, Israel.

出版信息

J Clin Med. 2024 Nov 23;13(23):7089. doi: 10.3390/jcm13237089.

Abstract

Individuals with diabetes face a higher risk of mobility disabilities, frailty, and sarcopenia (physical health agility). Studies have shown an association between HbA1C levels and physical health agility status. There is less information available about the relationship with time in range (%) (TIR). The aim of this study was to evaluate the cross-sectional relationship between time in range % (TIR %) and physical health agility status among older adults with type 2 diabetes (aerobic capacity, gait speed, strength, balance, and frailty). A cross-sectional study was conducted among individuals with diabetes over the age of 60. Participants were equipped with a blinded continuous glucose monitor (CGM) system (Medtronic iPro™2 and CareLink™, Medtronic, Northridge, CA, USA)) for 1 week and underwent an elaborate physical functional assessment (physical health agility) at the beginning and end of that week. The relationship between various physical health agility indices and both TIR (%) and HbA1c was evaluated using linear regression, with adjustments made for age and sex. This analysis pertains to 139 individuals over the age of 60 with type 2 diabetes. After adjustment for age and sex, a 1% higher TIR (70-180 mg/dL) was associated with a 0.169 better score on aerobic capacity and endurance (-value = 0.023), 0.119 better score on muscle strength of the upper limb (-value = 0.039), 0.164 better score on dynamic balance (-value = 0.039), and 0.165 better score on the evaluation of fall risk and balance (-value = 0.037). In older individuals with diabetes, a higher percentage of time in range (TIR) is linked to better physical agility status indices. Future research is needed to determine whether glucose levels are simply a marker of disease severity or if there is a potential causal relationship.

摘要

糖尿病患者面临行动不便、身体虚弱和肌肉减少症(身体健康灵活性)的风险更高。研究表明糖化血红蛋白(HbA1C)水平与身体健康灵活性状况之间存在关联。关于其与血糖达标时间百分比(TIR)之间关系的信息较少。本研究的目的是评估60岁及以上2型糖尿病老年人的血糖达标时间百分比(TIR%)与身体健康灵活性状况(有氧运动能力、步速、力量、平衡和身体虚弱)之间的横断面关系。对60岁以上的糖尿病患者进行了一项横断面研究。参与者佩戴了1周的盲法连续血糖监测(CGM)系统(美敦力iPro™2和CareLink™,美敦力公司,美国加利福尼亚州北岭),并在该周开始和结束时接受了详细的身体功能评估(身体健康灵活性)。使用线性回归评估各种身体健康灵活性指标与TIR(%)和HbA1c之间的关系,并对年龄和性别进行了调整。该分析涉及139名60岁以上的2型糖尿病患者。在对年龄和性别进行调整后,TIR(70-180mg/dL)每升高1%,有氧运动能力和耐力得分提高0.169分(P值=0.023),上肢肌肉力量得分提高0.119分(P值=0.039),动态平衡得分提高0.164分(P值=0.039),跌倒风险和平衡评估得分提高0.165分(P值=0.037)。在老年糖尿病患者中,血糖达标时间百分比(TIR)越高,身体灵活性状况指标越好。需要进一步的研究来确定血糖水平仅仅是疾病严重程度的一个指标,还是存在潜在的因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b9b/11642438/8afe821253fd/jcm-13-07089-g001.jpg

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