scholarly journals Associations between continuous glucose monitoring-derived metrics and arterial stiffness in Japanese patients with type 2 diabetes

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Satomi Wakasugi ◽  
Tomoya Mita ◽  
Naoto Katakami ◽  
Yosuke Okada ◽  
Hidenori Yoshii ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Arterial Stiffness ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
History Of ◽  
Atherosclerotic Risk Factors

Abstract Background Previous studies have suggested that high mean glucose levels and glycemic abnormalities such as glucose fluctuation and hypoglycemia accelerate the progression of atherosclerosis in patients with type 2 diabetes. Although continuous glucose monitoring (CGM) that could evaluate such glycemic abnormalities has been rapidly adopted, the associations between CGM-derived metrics and arterial stiffness are not entirely clear. Methods This exploratory cross-sectional study used baseline data from an ongoing prospective, multicenter, observational study with 5 years of follow-up. Study participants included 445 outpatients with type 2 diabetes and no history of apparent cardiovascular disease who underwent CGM and brachial-ankle pulse wave velocity (baPWV) measurement at baseline. Associations between CGM-derived metrics and baPWV were analyzed using multivariate regression models. Results In a linear regression model, all CGM-derived metrics were significantly associated with baPWV, but HbA1c was not. Some CGM-derived metrics related to intra-day glucose variability, hyperglycemia, and hypoglycemia remained significantly associated with baPWV after adjusting for possible atherosclerotic risk factors, including HbA1c. Based on baPWV ≥ 1800 cm/s as indicative of high arterial stiffness, multivariate logistic regression found that some CGM-derived metrics related to intra-day glucose variability and hyperglycemia are significantly associated with high arterial stiffness even after adjusting for possible atherosclerotic risk factors, including HbA1c. Conclusions Multiple CGM-derived metrics are significantly associated with baPWV and high arterial stiffness in patients with type 2 diabetes who have no history of apparent cardiovascular disease. These metrics might be useful for identifying patients at high risk of developing cardiovascular disease.

scholarly journals Associations Between Continuous Glucose Monitoring-derived Metrics and Arterial Stiffness in Patients with Type 2 Diabetes

2020 ◽  
Author(s):  
Satomi Wakasugi ◽  
Tomoya Mita ◽  
Naoto Katakami ◽  
Yosuke Okada ◽  
Hidenori Yoshii ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Arterial Stiffness ◽  
Continuous Glucose Monitoring ◽  
Medical Information ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
University Hospital ◽  
Atherosclerotic Risk Factors

Abstract Background Previous studies have suggested that high mean glucose levels and various glycemic abnormalities such as glucose fluctuation and hypoglycemia accelerate the progression of atherosclerosis in patients with type 2 diabetes. Although continuous glucose monitoring (CGM) that could evaluate such glycemic abnormalities has been rapidly adopted, the associations between CGM-derived metrics and arterial stiffness are not entirely clear. Methods This is an exploratory analysis of an ongoing prospective, multicenter, 5-year follow-up observational study. Study participants included 445 outpatients with type 2 diabetes who underwent CGM and brachial-ankle pulse wave velocity (baPWV) measurement at baseline. Associations between CGM-derived metrics and baPWV were investigated using multivariate regression models.Results In a linear regression model, all CGM–derived metrics were significantly associated with baPWV, but HbA1c was not. Some CGM–derived metrics related to intra-day glucose variability, hyperglycemia, and hypoglycemia remained significantly associated with baPWV after adjusting for possible atherosclerotic risk factors, including HbA1c. Based on baPWV ≥1,800 cm/s as indicative of high arterial stiffness, multivariate logistic regression found that some CGM-derived metrics related to intra-day glucose variability and hyperglycemia are significantly associated with high arterial stiffness even after adjusting for possible atherosclerotic risk factors, including HbA1c.Conclusions Multiple CGM-derived metrics are significantly associated with baPWV and high arterial stiffness in patients with type 2 diabetes who have no history of apparent cardiovascular disease. These metrics might be useful for identifying patients at high risk of developing cardiovascular disease.This study has been registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000032325).

scholarly journals Associations between continuous glucose monitoring-derived metrics and diabetic retinopathy and albuminuria in patients with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e001923
Author(s):  
Satomi Wakasugi ◽  
Tomoya Mita ◽  
Naoto Katakami ◽  
Yosuke Okada ◽  
Hidenori Yoshii ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Continuous Glucose Monitoring ◽  
Microvascular Complications ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Proportional Odds Models ◽  
Diabetic Microvascular Complications ◽  
Hba1c Levels

IntroductionPreventing the development and progression of diabetic microvascular complications through optimal blood glucose control remains an important challenge. Whether metrics based on continuous glucose monitoring are useful for the management of diabetic microvascular complications is not entirely clear.Research design and methodsThis is an exploratory analysis of an ongoing prospective, multicenter, 5-year follow-up observational study. Study participants included 999 outpatients with type 2 diabetes who underwent continuous glucose monitoring at baseline. Associations between continuous glucose monitoring-derived metrics and the severity of diabetic retinopathy or albuminuria were investigated using multivariable proportional odds models.ResultsThe overall prevalence of diabetic retinopathy was 22.2%. Multivariate analysis with proportional odds models demonstrated that continuous glucose monitoring-derived metrics related to intraday and interday glucose variability are significantly associated with the severity of diabetic retinopathy, even after adjusting for various possible risk factors. However, significant relationships were not observed after adjusting for hemoglobin A1c (HbA1c) levels. The prevalence of microalbuminuria and macroalbuminuria was 20.3% and 6.7%, respectively. Similarly, multivariate analysis demonstrated that those metrics are significantly associated with the severity of albuminuria. These relationships remained significant even after further adjusting for HbA1c levels.ConclusionsContinuous glucose monitoring-derived metrics related to intraday and interday glucose variability are significantly associated with the severity of diabetic retinopathy or albuminuria in patients with type 2 diabetes. Thus, evaluating these metrics might possibly be useful for risk assessment of diabetic microvascular complications.Trial registration number UMIN000032325.

Risk factors for diabetes, but not for cardiovascular disease, are associated with family history of Type 2 diabetes in subjects from central Mexico

2012 ◽  
Vol 39 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Irma Zamora-Ginez ◽  
Ricardo Pérez-Fuentes ◽  
Blanca G. Baez-Duarte ◽  
Cristina Revilla-Monsalve ◽  
Eduardo Brambila ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Family History ◽  
Central Mexico ◽  
History Of

The Glycemic Effect of Liraglutide Evaluated by Continuous Glucose Monitoring in Persons with Type 2 Diabetes Receiving Dialysis

Nephron ◽  
2020 ◽  
Vol 145 (1) ◽  
pp. 27-34
Author(s):  
Tobias Bomholt ◽  
Thomas Idorn ◽  
Filip K. Knop ◽  
Morten B. Jørgensen ◽  
Ajenthen G. Ranjan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Placebo Group ◽  
Continuous Glucose Monitoring ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Antidiabetic Treatment ◽  
Stage Renal Disease

<b><i>Aims:</i></b> The aim of this study was to evaluate the effect of liraglutide treatment on glucose variability and the risk of hypoglycemia by continuous glucose monitoring (CGM) in persons with type 2 diabetes (T2D) and dialysis-dependent end-stage renal disease (ESRD). <b><i>Materials and Methods:</i></b> We assessed CGM data from a previous trial where 24 persons with T2D and dialysis-dependent ESRD were allocated (1:1) to 12 weeks of double-blinded treatment with liraglutide (titrated to maximum tolerable dose up to 1.8 mg) or placebo as an add-on to preexisting antidiabetic treatment. CGM (Ipro2<sup>®</sup>; Medtronic) was performed for up to 7 days at baseline and at weeks 2, 6, and 10. A linear mixed model was used to compare the 2 study arms. <b><i>Results:</i></b> A CGM was worn at baseline by 12 persons in the liraglutide group and 10 in the placebo group (7 and 9 completed week 10, respectively). Glycated hemoglobin A<sub>1c</sub> (<i>p</i> = 0.81) and glucose variability was similar between the groups (standard deviation, <i>p</i> = 0.33; coefficient of variation, <i>p</i> = 0.16). Comparing baseline and week 10, the number of hypoglycemic events (glucose values between &#x3c;3.9 and 3.0 mmol/L) increased in the liraglutide group compared with the placebo group (<i>p</i> = 0.02). The occurrence of hypoglycemic events below 3.0 mmol/L was similar between the groups (<i>p</i> = 0.36). <b><i>Conclusions:</i></b> In the present cohort of persons with T2D and dialysis-dependent ESRD, liraglutide treatment increased the risk of hypoglycemic events as compared to placebo (no difference was found for hypoglycemic events below 3.0 mmol/L). The majority of participants were co-treated with insulin.

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