Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However...Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However,the association between time in range(TIR),as assessed by SMBG,andβ-cell insulin secretion as well as insulin sensitivity remains unexplored.Therefore,this study aims to investigate the connections between TIR,derived from SMBG,and indices representingβ-cell functionality and insulin sensitivity.The primary objective of this study was to elucidate the relationship between short-term glycemic control(measured as points in range[PIR])and bothβ-cell function and insulin sensitivity.Methods:This cross-sectional study enrolled 472 hospitalized patients with type 2 diabetes mellitus(T2DM).To assessβ-cell secretion capacity,we employed the insulin secretion-sensitivity index-2(ISSI-2)and(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,while insulin sensitivity was evaluated using the Matsuda index and HOMA-IR.Since SMBG offers glucose data at specific point-in-time,we substituted TIR with PIR.According to clinical guidelines,values falling within the range of 3.9-10 mmol were considered"in range,"and the corresponding percentage was calculated as PIR.Results:We observed significant associations between higher PIR quartiles and increased ISSI-2,(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,Matsuda index(increased)and HOMA-IR(decreased)(all P<0.001).PIR exhibited positive correlations with log ISSI-2(r=0.361,P<0.001),log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index(r=0.482,P<0.001),and log Matsuda index(r=0.178,P<0.001)and negative correlations with log HOMA-IR(r=-0.288,P<0.001).Furthermore,PIR emerged as an independent risk factor for log ISSI-2,log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,log Matsuda index,and log HOMA-IR.Conclusion:PIR can serve as a valuable tool for assessingβ-cell function and insulin sensitivity.展开更多
目的探讨德谷门冬双胰岛素与门冬胰岛素持续皮下输注在院内非内分泌科住院的糖尿病患者中治疗的有效性及安全性。方法回顾性分析2021年12月至2022年6月于郑州大学第五附属医院非内分泌科住院应用门冬胰岛素30注射液但血糖不达标的糖尿...目的探讨德谷门冬双胰岛素与门冬胰岛素持续皮下输注在院内非内分泌科住院的糖尿病患者中治疗的有效性及安全性。方法回顾性分析2021年12月至2022年6月于郑州大学第五附属医院非内分泌科住院应用门冬胰岛素30注射液但血糖不达标的糖尿病患者82例,其中调整为德谷门冬双胰岛素治疗50例(德谷门冬组),调整为胰岛素泵持续皮下输注门冬胰岛素治疗组32例(胰岛素泵组)。分析两组一般特征,治疗前后血糖、胰岛素用量变化,血糖达标时间,血糖在目标范围内的时间,血糖波动指标[平均血糖波动幅度(mean amplitude of glycemic excursion,MAGE)、血糖标准差(standard deviation of blood glucose,SDBG)、最大血糖波动幅度、日间血糖平均绝对差(absolute means of daily difference,MODD)],血糖达标时胰岛素用量,低血糖发生情况,患者及相关科室医生满意度等。结果治疗10天后两组血糖均明显下降,胰岛素用量均较治疗前明显减少(P<0.05);空腹血糖、治疗前后血糖变化、胰岛素用量变化、医生满意度两组差异无统计学意义(P>0.05);德谷门冬组低血糖发生率较低、患者满意度较高,两组差异有统计学意义(P<0.01);德谷门冬组SDBG、MAGE、MODD、血糖达标时间劣于胰岛素泵组,差异有统计学意义(P<0.05)。结论在非内分泌科住院的糖尿病患者中,德谷门冬双胰岛素与门冬胰岛素持续皮下输注均能有效控制血糖达标,节约胰岛素用量;德谷门冬胰岛素低血糖风险更低,患者满意度更高,但血糖达标时间较长、血糖波动较大。展开更多
Background:Time in range(TIR)refers to the time an individual spends within their target glucose range,which now has been popularized as an important metric to classify glycemic management and also recognized as an im...Background:Time in range(TIR)refers to the time an individual spends within their target glucose range,which now has been popularized as an important metric to classify glycemic management and also recognized as an important outcome of current diabetes therapies.This study aimed to investigate the association between TIR and the severity of the urinary albumin excretion rate(UAER)in patients with type 2 diabetes mellitus(T2DM).Methods:We retrospectively analyzed the data of 1014 inpatients with T2DM at the Department of Endocrinology and Metabolism of Peking University International Hospital,China.TIR was defined as the percentage of blood glucose within the target range of 3.90-10.00 mmol/L.Urine samples for assessment of UAER were collected for 3 consecutive days from the start of hospitalization.Results:The TIR values for patients with normal urine levels of albumin,microalbuminuria,and macroalbuminuria were 70%±20%,50%±20%,and 30%±20%,respectively(allP<0.001).The patients were stratified according to quartiles of TIR as follows:quartile(Q)1,<55%;Q2,55%-72%;Q3,73%-83%;and Q4,>83%.The incidences of microalbuminuria in Q1,Q2,Q3,and Q4 were 41.1%,21.6%,7.1%,and 5.5%(allP<0.001),respectively.The respective incidences of macroalbuminuria were 24.2%,1.1%,1.4%,and 0%(allP<0.001).In multinomial logistic regression analyses,TIR was significantly correlated with microalbuminuria(odds ratio[OR]0.58,95%confidence interval[CI]:0.52-0.65,P<0.001)and macroalbuminuria(OR 0.26,95%CI:0.18-0.38,P<0.001)after adjusting for age,sex,body mass index,diabetes duration,systolic blood pressure,and levels of triglycerides,glycosylated hemoglobin A1c,and creatinine.Conclusion:The proportion of blood glucose in TIR is closely related to the severity of UAER in patients with T2DM.展开更多
文摘Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However,the association between time in range(TIR),as assessed by SMBG,andβ-cell insulin secretion as well as insulin sensitivity remains unexplored.Therefore,this study aims to investigate the connections between TIR,derived from SMBG,and indices representingβ-cell functionality and insulin sensitivity.The primary objective of this study was to elucidate the relationship between short-term glycemic control(measured as points in range[PIR])and bothβ-cell function and insulin sensitivity.Methods:This cross-sectional study enrolled 472 hospitalized patients with type 2 diabetes mellitus(T2DM).To assessβ-cell secretion capacity,we employed the insulin secretion-sensitivity index-2(ISSI-2)and(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,while insulin sensitivity was evaluated using the Matsuda index and HOMA-IR.Since SMBG offers glucose data at specific point-in-time,we substituted TIR with PIR.According to clinical guidelines,values falling within the range of 3.9-10 mmol were considered"in range,"and the corresponding percentage was calculated as PIR.Results:We observed significant associations between higher PIR quartiles and increased ISSI-2,(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,Matsuda index(increased)and HOMA-IR(decreased)(all P<0.001).PIR exhibited positive correlations with log ISSI-2(r=0.361,P<0.001),log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index(r=0.482,P<0.001),and log Matsuda index(r=0.178,P<0.001)and negative correlations with log HOMA-IR(r=-0.288,P<0.001).Furthermore,PIR emerged as an independent risk factor for log ISSI-2,log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,log Matsuda index,and log HOMA-IR.Conclusion:PIR can serve as a valuable tool for assessingβ-cell function and insulin sensitivity.
文摘目的探讨德谷门冬双胰岛素与门冬胰岛素持续皮下输注在院内非内分泌科住院的糖尿病患者中治疗的有效性及安全性。方法回顾性分析2021年12月至2022年6月于郑州大学第五附属医院非内分泌科住院应用门冬胰岛素30注射液但血糖不达标的糖尿病患者82例,其中调整为德谷门冬双胰岛素治疗50例(德谷门冬组),调整为胰岛素泵持续皮下输注门冬胰岛素治疗组32例(胰岛素泵组)。分析两组一般特征,治疗前后血糖、胰岛素用量变化,血糖达标时间,血糖在目标范围内的时间,血糖波动指标[平均血糖波动幅度(mean amplitude of glycemic excursion,MAGE)、血糖标准差(standard deviation of blood glucose,SDBG)、最大血糖波动幅度、日间血糖平均绝对差(absolute means of daily difference,MODD)],血糖达标时胰岛素用量,低血糖发生情况,患者及相关科室医生满意度等。结果治疗10天后两组血糖均明显下降,胰岛素用量均较治疗前明显减少(P<0.05);空腹血糖、治疗前后血糖变化、胰岛素用量变化、医生满意度两组差异无统计学意义(P>0.05);德谷门冬组低血糖发生率较低、患者满意度较高,两组差异有统计学意义(P<0.01);德谷门冬组SDBG、MAGE、MODD、血糖达标时间劣于胰岛素泵组,差异有统计学意义(P<0.05)。结论在非内分泌科住院的糖尿病患者中,德谷门冬双胰岛素与门冬胰岛素持续皮下输注均能有效控制血糖达标,节约胰岛素用量;德谷门冬胰岛素低血糖风险更低,患者满意度更高,但血糖达标时间较长、血糖波动较大。
文摘Background:Time in range(TIR)refers to the time an individual spends within their target glucose range,which now has been popularized as an important metric to classify glycemic management and also recognized as an important outcome of current diabetes therapies.This study aimed to investigate the association between TIR and the severity of the urinary albumin excretion rate(UAER)in patients with type 2 diabetes mellitus(T2DM).Methods:We retrospectively analyzed the data of 1014 inpatients with T2DM at the Department of Endocrinology and Metabolism of Peking University International Hospital,China.TIR was defined as the percentage of blood glucose within the target range of 3.90-10.00 mmol/L.Urine samples for assessment of UAER were collected for 3 consecutive days from the start of hospitalization.Results:The TIR values for patients with normal urine levels of albumin,microalbuminuria,and macroalbuminuria were 70%±20%,50%±20%,and 30%±20%,respectively(allP<0.001).The patients were stratified according to quartiles of TIR as follows:quartile(Q)1,<55%;Q2,55%-72%;Q3,73%-83%;and Q4,>83%.The incidences of microalbuminuria in Q1,Q2,Q3,and Q4 were 41.1%,21.6%,7.1%,and 5.5%(allP<0.001),respectively.The respective incidences of macroalbuminuria were 24.2%,1.1%,1.4%,and 0%(allP<0.001).In multinomial logistic regression analyses,TIR was significantly correlated with microalbuminuria(odds ratio[OR]0.58,95%confidence interval[CI]:0.52-0.65,P<0.001)and macroalbuminuria(OR 0.26,95%CI:0.18-0.38,P<0.001)after adjusting for age,sex,body mass index,diabetes duration,systolic blood pressure,and levels of triglycerides,glycosylated hemoglobin A1c,and creatinine.Conclusion:The proportion of blood glucose in TIR is closely related to the severity of UAER in patients with T2DM.
