Association of Body Fat Percentage With Time in Range Generated by Continuous Glucose Monitoring During Intensive Insulin Pump Therapy in Type 2 Diabetes

Abstract BackgroundObesity is a crucial risk factor associated with type 2 diabetes mellitus (T2DM). Excessive accumulation of body fat may affect the glycemia control in T2DM. This study investigated the relationship between body fat percentage and time in range (TIR) assessed by continuous glucose monitoring (CGM) during short-term intensive insulin pump therapy in T2DM patients.MethodA total of 85 T2DM patients were recruited in this cross-sectional study. All participants underwent 72-h CGM period during intensive insulin pump therapy. TIR was defined as the percentage of time spent within the target glucose range of 3.9-10.0 mmol/L. Body composition was measured using bioelectrical impedance analysis (BIA) and overfat was defined as an amount of body fat of at least 25% of total body mass for men or at least 30% for women. Multiple linear regression models were used to evaluate the independent association of body fat percentage with TIR after adjusting for confounding factors.ResultsCompared with normal fat T2DM patients, individual with a higher body fat percentage exhibited lower levels of TIR (P=0.004) and higher 72h mean blood glucose (72h-MBG) (P=0.001) during intensive insulin pump therapy. The presence of overfat inversely correlated with TIR in T2DM populations (r = -0.306; P=0.004). Multiple linear regression analysis indicated that body fat percentage was significantly associated with TIR independent of HbA1c, insulin dosage and glycemic variability metrics (All P for trend <0.05). Further adjustment of other body composition parameters, including waist circumference, visceral fat area and muscle quantity, the link between body fat percentage and TIR remained significant (All P＜0.05).ConclusionsBody fat percentage was significantly associated with TIR in T2DM during intensive insulin pump therapy. Reduction of body fat may be an important therapeutic target to improve glycemic control in obese T2DM patients.

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Abstract #329 Insulin Pump Therapy in Older Adults with Type 2 Diabetes and Sporadic Glucose Monitoring: Balancing The Risk of Hypoglycemia Unawareness and Convenience

Endocrine Practice ◽

10.1016/s1530-891x(20)46673-x ◽

2019 ◽

Vol 25 ◽

pp. 142-143

Author(s):

Jordana Faruqi ◽

Kelly Ferguson ◽

L. Maria Belalcazar

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Insulin Pump ◽

Glucose Monitoring ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Hypoglycemia Unawareness

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Association of Body Fat Percentage with Time in Range Generated by Continuous Glucose Monitoring during Continuous Subcutaneous Insulin Infusion Therapy in Type 2 Diabetes

Journal of Diabetes Research ◽

10.1155/2021/5551216 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Yuting Ruan ◽

Jiana Zhong ◽

Rongping Chen ◽

Zhen Zhang ◽

Dixing Liu ◽

...

Keyword(s):

Body Fat ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Glucose Monitoring ◽

Body Fat Percentage ◽

Subcutaneous Insulin ◽

Fat Percentage ◽

Short Term ◽

Time In Range

Background. Obesity is a crucial risk factor associated with type 2 diabetes mellitus (T2DM). Excessive accumulation of body fat may affect the glycemia control in T2DM. This study investigated the relationship between body fat percentage and time in range (TIR) assessed by continuous glucose monitoring (CGM) during short-term continuous subcutaneous insulin infusion (CSII) therapy in T2DM patients. Method. A total of 85 T2DM patients were recruited in this cross-sectional study. All participants underwent 72 h CGM period during short-term CSII therapy. TIR was defined as the percentage of time spent within the target glucose range of 3.9-10.0 mmol/L. Body composition was measured using bioelectrical impedance analysis (BIA) and overfat was defined as an amount of body fat of at least 25% of total body mass for men or at least 30% for women. Multiple linear regression models were used to evaluate the independent association of body fat percentage with TIR after adjusting for confounding factors. Results. Compared with normal fat T2DM patients, individual with a higher body fat percentage exhibited lower levels of TIR ( P = 0.004 ) and higher 72 h mean blood glucose (72 h MBG) ( P = 0.001 ) during short-term CSII treatment. The prevalence of overfat assessed by body fat percentage decreased with the ascending TIR tertiles ( P < 0.05 ). Multiple linear regression analysis indicated that body fat percentage was significantly associated with TIR independent of age, gender, diabetes duration, HbA1c, and BMI ( P = 0.043 ). Conclusions. Body fat percentage was significantly associated with TIR in T2DM during short-term CSII therapy. Reduction of body fat may be an important therapeutic target to improve glycemic control in high body fat T2DM patients, who may benefit less from intensive insulin treatment.

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Retrospective Analysis and Patient Satisfaction Assessment of Insulin Pump Therapy in Patients with Type 2 Diabetes

Southern Medical Journal ◽

10.1097/smj.0b013e3181fa7230 ◽

2011 ◽

Vol 104 (1) ◽

pp. 24-28 ◽

Cited By ~ 12

Author(s):

Chad K. Gentry ◽

L. Brian Cross ◽

Benjamin N. Gross ◽

M. Shawn McFarland ◽

William H. Bestermann

Keyword(s):

Type 2 Diabetes ◽

Patient Satisfaction ◽

Retrospective Analysis ◽

Insulin Pump ◽

Insulin Pump Therapy ◽

Pump Therapy

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CopenFast trial: Faster-acting insulin Fiasp versus insulin NovoRapid in the treatment of women with type 1 or type 2 diabetes during pregnancy and lactation - a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-045650 ◽

2021 ◽

Vol 11 (4) ◽

pp. e045650

Author(s):

Sidse Kjærhus Nørgaard ◽

Elisabeth Reinhardt Mathiesen ◽

Kirsten Nørgaard ◽

Tine Dalsgaard Clausen ◽

Peter Damm ◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Pump ◽

Controlled Trial ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Acting Insulin ◽

Pregnancy And Lactation ◽

Randomised Controlled

IntroductionFaster-acting insulin aspart (Fiasp) is approved for use in pregnancy and lactation, but no clinical study has evaluated its effects during this life stage in women with pre-existing diabetes. The aim of the CopenFast trial is to evaluate the effect of Fiasp compared with insulin aspart (NovoRapid) on maternal glycaemic control during pregnancy, delivery and lactation and on fetal growth and infant health.Methods and analysisAn open-label randomised controlled trial of pregnant women with type 1 or type 2 diabetes including women on multiple daily injection (MDI) therapy or insulin pump therapy. During a 2-year inclusion period, approximately 220 women will be randomised 1:1 to Fiasp or NovoRapid in early pregnancy and followed until 3 months after delivery. At 9, 21 and 33 gestational weeks and during planned induction of labour or caesarean section, women are offered blinded continuous glucose monitoring (CGM) for 7 days. Randomisation will stratify for type of diabetes and insulin treatment modality (MDI or insulin pump therapy, respectively). Health status of the infants will be followed until 3 months of age. The primary outcome is birth weight SD score adjusted for gestational age and gender. Secondary outcomes include maternal glycaemic control including glycated haemoglobin, preprandial and postprandial self-monitored plasma glucose levels, episodes of mild and severe hypoglycaemia, maternal gestational weight gain and weight retention, CGM time spent in, above and below target ranges as well as pregnancy outcomes including pre-eclampsia, preterm delivery, perinatal mortality and neonatal morbidity. Data analysis will be performed according to the intention-to-treat principle.Ethics and disseminationThe trial has been approved by the Regional Ethics Committee (H-19029966) on 7 August 2019. Results will be sought disseminated in peer-reviewed journals and at scientific meetings.Trial registration numberNCT03770767

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