Elevated urinary albumin predicts increased time in range after initiation of SGLT2 inhibitors in individuals with type 1 diabetes on sensor-augmented pump therapy.

IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM
Diabetology International Pub Date : 2024-08-06 eCollection Date: 2024-10-01 DOI:10.1007/s13340-024-00743-4
Yuka Suganuma, Mizuki Ishiguro, Takayuki Ohno, Rimei Nishimura
{"title":"Elevated urinary albumin predicts increased time in range after initiation of SGLT2 inhibitors in individuals with type 1 diabetes on sensor-augmented pump therapy.","authors":"Yuka Suganuma, Mizuki Ishiguro, Takayuki Ohno, Rimei Nishimura","doi":"10.1007/s13340-024-00743-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>We aimed to investigate potential predictors of effectiveness of SGLT2 inhibitors (SGLT2i) in individuals with type 1 diabetes (T1D) on sensor-augmented pump (SAP) therapy.</p><p><strong>Methods: </strong>We included individuals with T1D receiving SAP therapy at our hospital who were newly initiated on SGLT2i between 2019 and 2020 and were followed for at least 1 year. Data on BMI, blood tests, and continuous glucose monitoring (CGM) were compared before and 12 months after initiation of SGLT2i. Predictors of incremental increases in time in range (ΔTIR) were explored using a multiple regression analysis. Cutoff values for the predictors were determined using an ROC curve analysis.</p><p><strong>Results: </strong>A total of 17 individuals (females, 70.6%; median age, 44.0 years) were included, excluding three individuals who discontinued SGLT2i due to side effects. During follow-up, their median BMI decreased significantly (<i>P</i> = 0.013), while no significant change was seen in their total daily dose of insulin, basal-to-total insulin ratio. Again, their HbA1c, TIR, and time above range (TAR) improved significantly (<i>P</i> = 0.004, <i>P</i> = 0.003, and <i>P</i> = 0.003, respectively), while their time below range (TBR) showed no significant change. The predictor of increased ΔTIR was high urinary albumin-to-creatinine ratio (UACR) at baseline (<i>P</i> = 0.026) only, with the cutoff value determined to be 28.0 mg/g Cr or higher (AUC = 0.82, <i>P</i> = 0.003).</p><p><strong>Conclusions: </strong>It may be suggested that individuals with T1D on SAP therapy and having near-microalbuminuria or higher could be expected to show significant improvement in TIR.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-024-00743-4.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"15 4","pages":"806-813"},"PeriodicalIF":1.3000,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512966/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13340-024-00743-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Aims: We aimed to investigate potential predictors of effectiveness of SGLT2 inhibitors (SGLT2i) in individuals with type 1 diabetes (T1D) on sensor-augmented pump (SAP) therapy.

Methods: We included individuals with T1D receiving SAP therapy at our hospital who were newly initiated on SGLT2i between 2019 and 2020 and were followed for at least 1 year. Data on BMI, blood tests, and continuous glucose monitoring (CGM) were compared before and 12 months after initiation of SGLT2i. Predictors of incremental increases in time in range (ΔTIR) were explored using a multiple regression analysis. Cutoff values for the predictors were determined using an ROC curve analysis.

Results: A total of 17 individuals (females, 70.6%; median age, 44.0 years) were included, excluding three individuals who discontinued SGLT2i due to side effects. During follow-up, their median BMI decreased significantly (P = 0.013), while no significant change was seen in their total daily dose of insulin, basal-to-total insulin ratio. Again, their HbA1c, TIR, and time above range (TAR) improved significantly (P = 0.004, P = 0.003, and P = 0.003, respectively), while their time below range (TBR) showed no significant change. The predictor of increased ΔTIR was high urinary albumin-to-creatinine ratio (UACR) at baseline (P = 0.026) only, with the cutoff value determined to be 28.0 mg/g Cr or higher (AUC = 0.82, P = 0.003).

Conclusions: It may be suggested that individuals with T1D on SAP therapy and having near-microalbuminuria or higher could be expected to show significant improvement in TIR.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-024-00743-4.

尿白蛋白升高可预测接受传感器增强泵治疗的 1 型糖尿病患者在开始使用 SGLT2 抑制剂后进入量程的时间延长。
目的:我们旨在研究SGLT2抑制剂(SGLT2i)对接受传感器增强泵(SAP)治疗的1型糖尿病(T1D)患者疗效的潜在预测因素:我们纳入了在本医院接受SAP治疗的T1D患者,他们在2019年至2020年间新开始使用SGLT2i,并接受了至少1年的随访。比较了开始使用 SGLT2i 之前和之后 12 个月的 BMI、血液化验和连续血糖监测(CGM)数据。采用多元回归分析探讨了在量程内时间(ΔTIR)递增的预测因素。通过 ROC 曲线分析确定了预测因素的临界值:共纳入 17 人(女性,70.6%;中位年龄,44.0 岁),其中不包括因副作用停用 SGLT2i 的 3 人。在随访期间,他们的中位体重指数显著下降(P = 0.013),而每日胰岛素总剂量、基础胰岛素与总胰岛素之比没有显著变化。同样,他们的 HbA1c、TIR 和高于量程的时间(TAR)也有明显改善(分别为 P = 0.004、P = 0.003 和 P = 0.003),而低于量程的时间(TBR)则无明显变化。预测ΔTIR升高的因素仅是基线时尿白蛋白与肌酐比值(UACR)偏高(P = 0.026),其临界值被确定为 28.0 mg/g Cr 或更高(AUC = 0.82,P = 0.003):结论:可以认为,接受SAP治疗的T1D患者,如果有近微量白蛋白尿或更高,TIR有望得到显著改善:在线版本包含补充材料,可在10.1007/s13340-024-00743-4上查阅。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Diabetology International
Diabetology International ENDOCRINOLOGY & METABOLISM-
CiteScore
3.90
自引率
4.50%
发文量
42
期刊介绍: Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信