New insights from continuous glucose monitoring into the route to diabetes.

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  • Additional Information
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 100883450 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1520-7560 (Electronic) Linking ISSN: 15207552 NLM ISO Abbreviation: Diabetes Metab Res Rev Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford, England : Wiley-Blackwell, c1999-
    • Subject Terms:
      Biomarkers/*blood ; Blood Glucose/*analysis ; Blood Glucose Self-Monitoring/*methods ; Diabetes Mellitus, Type 2/*diagnosis ; Glucose Intolerance/*diagnosis ; Hypertension/*complications ; Prediabetic State/*diagnosis; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/etiology ; Female ; Follow-Up Studies ; Glucose Intolerance/blood ; Glucose Intolerance/etiology ; Humans ; Male ; Middle Aged ; Prediabetic State/blood ; Prediabetic State/etiology ; Prognosis ; Survival Rate ; Young Adult
    • Abstract:
      Aim: Type 2 diabetes mellitus (T2DM) is preceded by a period of impaired glucoregulation. We investigated if continuous glucose monitoring system (CGMS) (1) could improve our capacity to predict the development of T2DM in subjects at risk. (2) Find out if impaired fasting glucose/impaired glucose tolerance differentiation through CGMS would also elucidate differences in clinical phenotypes.
      Material and Methods: Observational study of 209 hypertensive patients, aged 18 to 85 years who wore at entry a CGMS. Two CGMS metrics, percent of time under the 100 mg/dL glycaemic threshold (TU100) (impaired fasting glucose surrogate phenotype) and area above the 140 mg/dL glycemic threshold (AO140) (impaired glucose tolerance surrogate phenotype) were measured. The median follow-up was 32 months (6-72 mo), and there were 17 new cases of T2DM.
      Results: In a multivariate Cox proportional hazard survival analysis including the conventional prediabetes-defining criteria and the 2 CGMS-derived variables, only TU100 and HbA 1c were significant and independent variables in predicting T2DM development. An increase in 0.1 in TU100 resulted in a 0.69 (95% CI, 0.54-0.88; P < .01) odds ratio of developing T2DM. With cut-off points of 0.5 for TU100 and 5.7% for HbA 1c , the test "TU < 0.5 and HbA 1c  > 5.7%" had a sensitivity of 0.81 (SD, 0.10), a specificity of 0.83 (SD, 0.03), and a likelihood ratio of 4.82 (SD, 1.03) for T2DM development.
      Conclusions: Continuous glucose monitoring system allows for a better T2DM risk-development categorization than fasting glucose and HbA 1c in a high-risk population. Continuous glucose monitoring system-derived phenotyping reveals clinical differences, not disclosed by conventional fasting plasma glucose/HbA 1c categorization. These differences may correlate with distinct pathophysiological mechanisms.
      (Copyright © 2018 John Wiley & Sons, Ltd.)
    • Contributed Indexing:
      Keywords: continuous glucose monitoring system; diabetes risk development; impaired fasting glucose; impaired glucose tolerance
    • Accession Number:
      0 (Biomarkers)
      0 (Blood Glucose)
    • Publication Date:
      Date Created: 20180309 Date Completed: 20181127 Latest Revision: 20181127
    • Publication Date:
      20240829
    • Accession Number:
      10.1002/dmrr.3002
    • Accession Number:
      29516622