2090-P: High Day-to-Day Glycemic Variability in Youth-Onset Type 2 Diabetes

IF 9.3 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Pub Date : 2026-06-11 DOI:10.2337/db26-2090-p

NICOLE RANGOS, ILA N. KACKER, MADILYN M. GAYDOS, SAMSON L. CANTOR, NATHAN GRANT SALA, NATALIE A. MACHERET, LILIAN MABUNDO, NOEMI MALANDRINO, DORIS E. ESTRADA, STEPHANIE CHUNG

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引用次数: 0

Abstract

Introduction and Objective: Free-living glycemic variability (GV), measured by continuous glucose monitors (CGM), is an independent risk factor for cardiovascular disease (CVD) in adults with diabetes, but GV data in youth-onset type 2 diabetes (Y-T2D) is scarce. To identify CVD risk factors in Y-T2D, we characterized GV in Y-T2D. Methods: This was a pooled cohort secondary analysis in Y-T2D enrolled in clinical trials between 2021-2025. GV within a day was measured by glucose standard deviation (SD) and GV between days was measured with mean of daily differences (MODD) using Dexcom CGM over 7-10 days. The relationship with contemporaneous HbA1c was assessed with Spearman’s correlation and linear regression, adjusted for age and BMI. Results: In 52 Y-T2D participants (age 17.0±4.4y, 33% male; 81% Black; 14% Hispanic/Latino; BMI 38.7±10.1 kg/m2, mean±SD), 10 were on basal insulin and 26 were on a glucagon-like peptide-1 receptor agonist. Median HbA1c was 6.3% (5.5, 7.6%) (25th, 75th percentile). Average CGM wear time was 8.7±1.6 days. SD and MODD were elevated at 27 (18, 41 mg/dL) and 25 (16, 37 mg/dL), respectfully. GV correlated with HbA1c and a 1% increase in HbA1c increased GV by ~3 mg/dL (Figure 1). Only insulin therapy was associated with higher HbA1c (10.8 vs. 6%, P<0.01), SD (46 vs. 24 mg/dl, P<0.01), and MODD (46 vs. 22 mg/dl, P<0.01). Conclusion: GV was high in Y-T2D, implying increased risk for CVD beyond HbA1c. Future studies examining CVD risk in Y-T2D should consider both GV and HbA1c. Disclosure N. Rangos: None. I.N. Kacker: None. M.M. Gaydos: None. S.L. Cantor: None. N. Sala: None. N.A. Macheret: None. L. Mabundo: None. N. Malandrino: None. D.E. Estrada: None. S. Chung: None. Funding NIDDK, NIH Z99 DK 999999

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2090-P：年轻发病的2型糖尿病的高日常血糖变异性

简介和目的：通过连续血糖监测仪（CGM）测量的游离血糖变异性（GV）是成人糖尿病患者心血管疾病（CVD）的独立危险因素，但青年发病2型糖尿病（Y-T2D）的GV数据很少。为了确定Y-T2D的CVD危险因素，我们对Y-T2D的GV进行了表征。方法：这是一项汇总队列二级分析，纳入2021-2025年临床试验的Y-T2D患者。用葡萄糖标准偏差（SD）测量一天内的GV，用Dexcom CGM测量7-10天内的日均差（MODD）测量天间的GV。采用Spearman相关和线性回归评估与同期HbA1c的关系，并根据年龄和BMI进行调整。结果：52名Y-T2D参与者（年龄17.0±4.4岁，33%男性，81%黑人，14%西班牙裔/拉丁裔，BMI 38.7±10.1 kg/m2，平均±SD）， 10人接受基础胰岛素治疗，26人接受胰高血糖素样肽-1受体激动剂治疗。中位HbA1c为6.3%(5.5%,7.6%)（第25、75百分位）。CGM平均磨损时间为8.7±1.6 d。SD和MODD分别升高至27（18、41 mg/dL）和25（16、37 mg/dL）。GV与HbA1c相关，HbA1c升高1%，GV升高约3mg /dL（图1）。只有胰岛素治疗与较高的HbA1c （10.8 vs. 6%, P<0.01）、SD （46 vs. 24 mg/dl, P<0.01）和MODD （46 vs. 22 mg/dl, P<0.01）相关。结论：Y-T2D患者GV较高，意味着HbA1c水平以上患者CVD风险增加。未来关于Y-T2D患者心血管疾病风险的研究应同时考虑GV和HbA1c。N.兰戈斯：没有。卡克尔：没有。盖多斯：没有。康托：没有。萨拉：没有。马切雷：没有。L.马本多：没有。N. Malandrino：没有。D.E. Estrada：没有。钟：没有。资助NIDDK， NIH Z99 DK 999999

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来源期刊

Diabetes 医学-内分泌学与代谢

CiteScore

12.50

自引率

2.60%

发文量

1968

审稿时长

1 months

期刊介绍： Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes. However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.