基于连续血糖监测的数字表型支持2型糖尿病患者个性化生活方式药物的可行性

IF 3.9 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2024-12-27 DOI:10.1016/j.maturitas.2024.108188

Willem J. van den Brink , Tim J. van den Broek , Suzan Wopereis , Sonia Difrancesco , Frans A.L. van der Horst , Iris M. de Hoogh

{"title":"基于连续血糖监测的数字表型支持2型糖尿病患者个性化生活方式药物的可行性","authors":"Willem J. van den Brink , Tim J. van den Broek , Suzan Wopereis , Sonia Difrancesco , Frans A.L. van der Horst , Iris M. de Hoogh","doi":"10.1016/j.maturitas.2024.108188","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Type 2 diabetes is a highly prevalent age-related chronic condition, with complex and heterogeneous pathogenesis. A 5-point oral glucose tolerance test can identify type 2 diabetes subtypes or “diabetypes” based on the degree of insulin resistance in muscle and/or liver, and beta-cell dysfunction. Due to its costly and invasive nature, the oral glucose tolerance test is not scalable. Presuming that differences in glucose and insulin dynamics manifest in continuous glucose monitoring profiles, we explore the potential of continuous glucose metrics to replace the oral glucose tolerance test for diabetyping.</div></div><div><h3>Study design</h3><div>In a prospective intervention study, 41 people with type 2 diabetes on lifestyle and/or metformin treatment wore a continuous glucose monitor during 3 control periods of 4 days. During each control period, participants underwent a 5-point oral glucose tolerance test after an overnight fast.</div></div><div><h3>Main outcome measures</h3><div>Continuous glucose monitoring data from the control periods, excluding the day of the oral glucose tolerance test, was retrospectively analyzed for associations with diabetypes, as well as Spearman correlations between bootstrapped continuous glucose features, including physiology-based and other time-series features, and oral glucose tolerance metrics.</div></div><div><h3>Results</h3><div>Significant associations were observed between continuous glucose metrics (e.g., low and high blood glucose index, eA1c, and glucose excursions) and oral glucose tolerance metrics (e.g., 2-h glucose, disposition index, insulinogenic index). Furthermore, data-driven metrics (e.g., maximum shift, lumpiness) showed more selective correlations, indicating that data-driven metrics may contain additional information associated with oral glucose tolerance metrics.</div></div><div><h3>Conclusions</h3><div>These results indicate the potential of continuous glucose monitoring to replace the oral glucose tolerance test for diabetyping, driving proactive and personalized (lifestyle) treatment.</div></div><div><h3>Netherlands trial register</h3><div>NL7848</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"194 ","pages":"Article 108188"},"PeriodicalIF":3.9000,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Feasibility of digital phenotyping based on continuous glucose monitoring to support personalized lifestyle medicine in type 2 diabetes\",\"authors\":\"Willem J. van den Brink , Tim J. van den Broek , Suzan Wopereis , Sonia Difrancesco , Frans A.L. van der Horst , Iris M. de Hoogh\",\"doi\":\"10.1016/j.maturitas.2024.108188\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>Type 2 diabetes is a highly prevalent age-related chronic condition, with complex and heterogeneous pathogenesis. A 5-point oral glucose tolerance test can identify type 2 diabetes subtypes or “diabetypes” based on the degree of insulin resistance in muscle and/or liver, and beta-cell dysfunction. Due to its costly and invasive nature, the oral glucose tolerance test is not scalable. Presuming that differences in glucose and insulin dynamics manifest in continuous glucose monitoring profiles, we explore the potential of continuous glucose metrics to replace the oral glucose tolerance test for diabetyping.</div></div><div><h3>Study design</h3><div>In a prospective intervention study, 41 people with type 2 diabetes on lifestyle and/or metformin treatment wore a continuous glucose monitor during 3 control periods of 4 days. During each control period, participants underwent a 5-point oral glucose tolerance test after an overnight fast.</div></div><div><h3>Main outcome measures</h3><div>Continuous glucose monitoring data from the control periods, excluding the day of the oral glucose tolerance test, was retrospectively analyzed for associations with diabetypes, as well as Spearman correlations between bootstrapped continuous glucose features, including physiology-based and other time-series features, and oral glucose tolerance metrics.</div></div><div><h3>Results</h3><div>Significant associations were observed between continuous glucose metrics (e.g., low and high blood glucose index, eA1c, and glucose excursions) and oral glucose tolerance metrics (e.g., 2-h glucose, disposition index, insulinogenic index). Furthermore, data-driven metrics (e.g., maximum shift, lumpiness) showed more selective correlations, indicating that data-driven metrics may contain additional information associated with oral glucose tolerance metrics.</div></div><div><h3>Conclusions</h3><div>These results indicate the potential of continuous glucose monitoring to replace the oral glucose tolerance test for diabetyping, driving proactive and personalized (lifestyle) treatment.</div></div><div><h3>Netherlands trial register</h3><div>NL7848</div></div>\",\"PeriodicalId\":51120,\"journal\":{\"name\":\"Maturitas\",\"volume\":\"194 \",\"pages\":\"Article 108188\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-12-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Maturitas\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0378512224002834\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Maturitas","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0378512224002834","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：2型糖尿病是一种高度流行的与年龄相关的慢性疾病，具有复杂和异质性的发病机制。5点口服葡萄糖耐量试验可以根据肌肉和/或肝脏的胰岛素抵抗程度以及β细胞功能障碍来识别2型糖尿病亚型或“糖尿病型”。由于其昂贵和侵入性，口服葡萄糖耐量试验是不可扩展的。假设葡萄糖和胰岛素动态的差异在连续血糖监测中表现出来，我们探索了连续血糖指标取代口服葡萄糖耐量试验的潜力。研究设计：在一项前瞻性干预研究中，41名接受生活方式和/或二甲双胍治疗的2型糖尿病患者在3个4天的控制期内连续监测血糖。在每个对照期，参与者在禁食一夜后进行5点口服葡萄糖耐量试验。主要结局指标：回顾性分析对照期（不包括口服糖耐量试验当天）的连续血糖监测数据与糖尿病的相关性，以及自引导连续血糖特征（包括基于生理的和其他时间序列特征）与口服糖耐量指标之间的Spearman相关性。结果：在连续血糖指标（如低血糖和高血糖指数、eA1c和葡萄糖漂移）和口服糖耐量指标（如2小时葡萄糖、倾向指数、胰岛素原指数）之间观察到显著相关性。此外，数据驱动的指标（例如，最大位移，块状）显示出更多的选择性相关性，表明数据驱动的指标可能包含与口服葡萄糖耐量指标相关的其他信息。结论：这些结果表明，连续血糖监测有可能取代口服糖耐量试验进行糖尿病分型，推动积极和个性化（生活方式）治疗。荷兰试验注册号：NL7848。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Feasibility of digital phenotyping based on continuous glucose monitoring to support personalized lifestyle medicine in type 2 diabetes

Objectives

Type 2 diabetes is a highly prevalent age-related chronic condition, with complex and heterogeneous pathogenesis. A 5-point oral glucose tolerance test can identify type 2 diabetes subtypes or “diabetypes” based on the degree of insulin resistance in muscle and/or liver, and beta-cell dysfunction. Due to its costly and invasive nature, the oral glucose tolerance test is not scalable. Presuming that differences in glucose and insulin dynamics manifest in continuous glucose monitoring profiles, we explore the potential of continuous glucose metrics to replace the oral glucose tolerance test for diabetyping.

Study design

In a prospective intervention study, 41 people with type 2 diabetes on lifestyle and/or metformin treatment wore a continuous glucose monitor during 3 control periods of 4 days. During each control period, participants underwent a 5-point oral glucose tolerance test after an overnight fast.

Main outcome measures

Continuous glucose monitoring data from the control periods, excluding the day of the oral glucose tolerance test, was retrospectively analyzed for associations with diabetypes, as well as Spearman correlations between bootstrapped continuous glucose features, including physiology-based and other time-series features, and oral glucose tolerance metrics.

Results

Significant associations were observed between continuous glucose metrics (e.g., low and high blood glucose index, eA1c, and glucose excursions) and oral glucose tolerance metrics (e.g., 2-h glucose, disposition index, insulinogenic index). Furthermore, data-driven metrics (e.g., maximum shift, lumpiness) showed more selective correlations, indicating that data-driven metrics may contain additional information associated with oral glucose tolerance metrics.

Conclusions

These results indicate the potential of continuous glucose monitoring to replace the oral glucose tolerance test for diabetyping, driving proactive and personalized (lifestyle) treatment.

Netherlands trial register

NL7848

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life