Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes
Objective. The objective of this study is to investigate the relationship between time in range (TIR), a new metric of continuous glucose monitoring (CGM) and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (T2DM). Methods. A total of 349 individuals with T2DM...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2020/5817074 |
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| author | Qingyu Guo Pu Zang Shaoying Xu Wenjing Song Zhen Zhang Chunyan Liu Zhanhong Guo Jing Chen Bin Lu Ping Gu Jiaqing Shao |
| author_facet | Qingyu Guo Pu Zang Shaoying Xu Wenjing Song Zhen Zhang Chunyan Liu Zhanhong Guo Jing Chen Bin Lu Ping Gu Jiaqing Shao |
| author_sort | Qingyu Guo |
| collection | DOAJ |
| description | Objective. The objective of this study is to investigate the relationship between time in range (TIR), a new metric of continuous glucose monitoring (CGM) and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (T2DM). Methods. A total of 349 individuals with T2DM were enrolled in this study. Evaluating by the standard cardiac autonomic reflex tests (CARTs), there were 228 diabetic individuals without cardiovascular autonomic neuropathy (without confirmed CAN) including absent CAN (n=83 cases) and early CAN (n=145 cases) and 121 diabetic individuals complicated with cardiovascular autonomic neuropathy (CAN) including definite CAN (n=109 cases) and severe CAN (n=12 cases). All patients underwent 3-day CGM. TIR is defined as the time percent during a 24-hour period when the glucose is in the range of 3.9-10 mmol/L. The Spearman analysis was used to analyze the correlation between TIR and CART parameters, total CAN score. The logistic regression was applied to analyze the relationship between TIR and CAN by adjusting for the age, duration of diabetes, sex, lipid situation, serum creatinine, body mass index, blood pressure, HbA1c (%), and other glycemic variability (GV) metrics. Results. The total presence of CAN was 34.67% (definite CAN 31.23% and severe CAN 3.44%). Patients with more severe CAN had lower TIR (P<0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P<0.05). TIR is inversely correlated with total score of CAN (P<0.001) and positively associated with heart rate variation during the lying to standing, Valsalva maneuver, and deep breathing (P<0.05). The logistic regression found a robust association between TIR and CAN independent of HbA1c and GV metrics. Conclusion. TIR is associated with the presence of CAN independent of HbA1c and GV metrics in Chinese type 2 diabetes. |
| format | Article |
| id | doaj-art-f7306733679a4c999ea3455a98789e68 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-f7306733679a4c999ea3455a98789e682025-02-03T06:43:41ZengWileyJournal of Diabetes Research2314-67452314-67532020-01-01202010.1155/2020/58170745817074Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 DiabetesQingyu Guo0Pu Zang1Shaoying Xu2Wenjing Song3Zhen Zhang4Chunyan Liu5Zhanhong Guo6Jing Chen7Bin Lu8Ping Gu9Jiaqing Shao10Jinling Hosp Dept Endocrinology, Nanjing Univ, Sch Med, Nanjing, ChinaJinling Hosp Dept Endocrinology, Nanjing Univ, Sch Med, Nanjing, ChinaJinling Hosp Dept Endocrinology, Southeast Univ, Sch Med, Nanjing, ChinaShanghai Sixth People's Hospital East, Shanghai, ChinaThe Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, ChinaAffiliated Hospital of Jiangnan University, Wuxi, ChinaJinling Hosp Dept Endocrinology, Nanjing Med Univ, Nanjing, ChinaJinling Hosp Dept Endocrinology, Southeast Univ, Sch Med, Nanjing, ChinaJinling Hosp Dept Endocrinology, Nanjing Univ, Sch Med, Nanjing, ChinaJinling Hosp Dept Endocrinology, Nanjing Univ, Sch Med, Nanjing, ChinaJinling Hosp Dept Endocrinology, Nanjing Univ, Sch Med, Nanjing, ChinaObjective. The objective of this study is to investigate the relationship between time in range (TIR), a new metric of continuous glucose monitoring (CGM) and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (T2DM). Methods. A total of 349 individuals with T2DM were enrolled in this study. Evaluating by the standard cardiac autonomic reflex tests (CARTs), there were 228 diabetic individuals without cardiovascular autonomic neuropathy (without confirmed CAN) including absent CAN (n=83 cases) and early CAN (n=145 cases) and 121 diabetic individuals complicated with cardiovascular autonomic neuropathy (CAN) including definite CAN (n=109 cases) and severe CAN (n=12 cases). All patients underwent 3-day CGM. TIR is defined as the time percent during a 24-hour period when the glucose is in the range of 3.9-10 mmol/L. The Spearman analysis was used to analyze the correlation between TIR and CART parameters, total CAN score. The logistic regression was applied to analyze the relationship between TIR and CAN by adjusting for the age, duration of diabetes, sex, lipid situation, serum creatinine, body mass index, blood pressure, HbA1c (%), and other glycemic variability (GV) metrics. Results. The total presence of CAN was 34.67% (definite CAN 31.23% and severe CAN 3.44%). Patients with more severe CAN had lower TIR (P<0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P<0.05). TIR is inversely correlated with total score of CAN (P<0.001) and positively associated with heart rate variation during the lying to standing, Valsalva maneuver, and deep breathing (P<0.05). The logistic regression found a robust association between TIR and CAN independent of HbA1c and GV metrics. Conclusion. TIR is associated with the presence of CAN independent of HbA1c and GV metrics in Chinese type 2 diabetes.http://dx.doi.org/10.1155/2020/5817074 |
| spellingShingle | Qingyu Guo Pu Zang Shaoying Xu Wenjing Song Zhen Zhang Chunyan Liu Zhanhong Guo Jing Chen Bin Lu Ping Gu Jiaqing Shao Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes Journal of Diabetes Research |
| title | Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes |
| title_full | Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes |
| title_fullStr | Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes |
| title_full_unstemmed | Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes |
| title_short | Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes |
| title_sort | time in range as a novel metric of glycemic control is reversely associated with presence of diabetic cardiovascular autonomic neuropathy independent of hba1c in chinese type 2 diabetes |
| url | http://dx.doi.org/10.1155/2020/5817074 |
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