Ayman Al Hayek, Malak Al Mashali, Mohamed A Al Dawish
{"title":"评估1型糖尿病的血糖危险指数和连续血糖监测衍生指标：一项真实世界的观察性研究。","authors":"Ayman Al Hayek, Malak Al Mashali, Mohamed A Al Dawish","doi":"10.1007/s40200-025-01569-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The Glycemia Risk Index (GRI) quantifies the risk of glycemic events by considering both hypoglycemic and hyperglycemic episodes, offering a comprehensive evaluation of glycemia. While associations between GRI and various glycometric indicators have been established in clinical trials using continuous glucose monitoring (CGM), real-world assessments, particularly with intermittent scanning CGM (isCGM), are underexplored. This study examines these associations and their clinical implications in individuals with Type 1 Diabetes (T1D).</p><p><strong>Methods: </strong>We conducted a retrospective study involving individuals with T1D undergoing intensive insulin therapy. All participants had used isCGM for at least three months. We collected clinical, metabolic, and glycemic data and calculated the GRI, with its components for hypoglycemia (CHypo) and hyperglycemia (CHyper). We then assessed the correlation between the GRI and traditional glycemic metrics in relation to the coefficient of variation (CV).</p><p><strong>Results: </strong>The study included 194 patients (105 males, 89 females) with a median age of 21.5 years for adults and 16 years for adolescents. Of these, 62.4% were on multiple daily injections, and 37.6% used insulin pumps. GRI showed a significant negative correlation with Time in Range (%TIR<sub>70 - 180</sub>) (<i>p</i> <i> < 0.001</i>) and a positive association with various glycemic measures such as glycemic variability (<i>r</i> = 0.33, <i>p</i> < 0.001). Individuals with lower glycemic variability (CV<sub>< 36%</sub>) had significantly higher %TIR<sub>70 - 180</sub> (63% vs. 39%, <i>p</i> < 0.01) and lower GRI (40 vs. 45.8, <i>p</i> < 0.01), CHyper (20 vs. 24, <i>p</i> = 0.01), and CHypo (2.6 vs. 3.4, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>GRI correlates with key glycemic metrics, indicating its potential utility in comprehensive glycemia assessment. These findings highlight the importance of individualized treatment approaches and suggest GRI's clinical relevance in optimizing glycemic management strategies for individuals with T1D.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-025-01569-w.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 1","pages":"59"},"PeriodicalIF":1.6000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787086/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of glycemia risk index and continuous glucose monitoring-derived metrics in type 1 diabetes: a real-world observational study.\",\"authors\":\"Ayman Al Hayek, Malak Al Mashali, Mohamed A Al Dawish\",\"doi\":\"10.1007/s40200-025-01569-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The Glycemia Risk Index (GRI) quantifies the risk of glycemic events by considering both hypoglycemic and hyperglycemic episodes, offering a comprehensive evaluation of glycemia. While associations between GRI and various glycometric indicators have been established in clinical trials using continuous glucose monitoring (CGM), real-world assessments, particularly with intermittent scanning CGM (isCGM), are underexplored. This study examines these associations and their clinical implications in individuals with Type 1 Diabetes (T1D).</p><p><strong>Methods: </strong>We conducted a retrospective study involving individuals with T1D undergoing intensive insulin therapy. All participants had used isCGM for at least three months. We collected clinical, metabolic, and glycemic data and calculated the GRI, with its components for hypoglycemia (CHypo) and hyperglycemia (CHyper). We then assessed the correlation between the GRI and traditional glycemic metrics in relation to the coefficient of variation (CV).</p><p><strong>Results: </strong>The study included 194 patients (105 males, 89 females) with a median age of 21.5 years for adults and 16 years for adolescents. Of these, 62.4% were on multiple daily injections, and 37.6% used insulin pumps. GRI showed a significant negative correlation with Time in Range (%TIR<sub>70 - 180</sub>) (<i>p</i> <i> < 0.001</i>) and a positive association with various glycemic measures such as glycemic variability (<i>r</i> = 0.33, <i>p</i> < 0.001). Individuals with lower glycemic variability (CV<sub>< 36%</sub>) had significantly higher %TIR<sub>70 - 180</sub> (63% vs. 39%, <i>p</i> < 0.01) and lower GRI (40 vs. 45.8, <i>p</i> < 0.01), CHyper (20 vs. 24, <i>p</i> = 0.01), and CHypo (2.6 vs. 3.4, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>GRI correlates with key glycemic metrics, indicating its potential utility in comprehensive glycemia assessment. 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引用次数: 0
摘要
目的：血糖风险指数（GRI）通过考虑低血糖和高血糖发作来量化血糖事件的风险，提供对血糖的综合评估。虽然在使用连续血糖监测（CGM）的临床试验中已经建立了GRI和各种血糖测量指标之间的关联，但实际评估，特别是间歇性扫描CGM (isCGM)，尚未得到充分探讨。本研究探讨了这些关联及其在1型糖尿病（T1D）患者中的临床意义。方法：我们对接受胰岛素强化治疗的T1D患者进行了回顾性研究。所有参与者使用isCGM至少三个月。我们收集了临床、代谢和血糖数据，并计算了GRI及其低血糖（CHypo）和高血糖（CHyper）的成分。然后，我们评估了GRI和传统血糖指标与变异系数（CV）之间的相关性。结果：研究纳入194例患者（男性105例，女性89例），成人中位年龄21.5岁，青少年中位年龄16岁。其中，62.4%的人每天多次注射，37.6%的人使用胰岛素泵。GRI与Time in Range (%TIR70 - 180) (p)呈显著负相关，与血糖变异性（r = 0.33, p）呈正相关，其中TIR70 - 180 %（63%对39%，p = 0.01）和CHypo（2.6对3.4,p）显著升高。结论：GRI与关键血糖指标相关，表明其在综合血糖评估中的潜在效用。这些发现强调了个体化治疗方法的重要性，并表明GRI在优化T1D患者血糖管理策略方面具有临床意义。补充信息：在线版本包含补充资料，提供地址：10.1007/s40200-025-01569-w。
Evaluation of glycemia risk index and continuous glucose monitoring-derived metrics in type 1 diabetes: a real-world observational study.
Objectives: The Glycemia Risk Index (GRI) quantifies the risk of glycemic events by considering both hypoglycemic and hyperglycemic episodes, offering a comprehensive evaluation of glycemia. While associations between GRI and various glycometric indicators have been established in clinical trials using continuous glucose monitoring (CGM), real-world assessments, particularly with intermittent scanning CGM (isCGM), are underexplored. This study examines these associations and their clinical implications in individuals with Type 1 Diabetes (T1D).
Methods: We conducted a retrospective study involving individuals with T1D undergoing intensive insulin therapy. All participants had used isCGM for at least three months. We collected clinical, metabolic, and glycemic data and calculated the GRI, with its components for hypoglycemia (CHypo) and hyperglycemia (CHyper). We then assessed the correlation between the GRI and traditional glycemic metrics in relation to the coefficient of variation (CV).
Results: The study included 194 patients (105 males, 89 females) with a median age of 21.5 years for adults and 16 years for adolescents. Of these, 62.4% were on multiple daily injections, and 37.6% used insulin pumps. GRI showed a significant negative correlation with Time in Range (%TIR70 - 180) (p < 0.001) and a positive association with various glycemic measures such as glycemic variability (r = 0.33, p < 0.001). Individuals with lower glycemic variability (CV< 36%) had significantly higher %TIR70 - 180 (63% vs. 39%, p < 0.01) and lower GRI (40 vs. 45.8, p < 0.01), CHyper (20 vs. 24, p = 0.01), and CHypo (2.6 vs. 3.4, p < 0.01).
Conclusions: GRI correlates with key glycemic metrics, indicating its potential utility in comprehensive glycemia assessment. These findings highlight the importance of individualized treatment approaches and suggest GRI's clinical relevance in optimizing glycemic management strategies for individuals with T1D.
Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01569-w.
期刊介绍：
Journal of Diabetes & Metabolic Disorders is a peer reviewed journal which publishes original clinical and translational articles and reviews in the field of endocrinology and provides a forum of debate of the highest quality on these issues. Topics of interest include, but are not limited to, diabetes, lipid disorders, metabolic disorders, osteoporosis, interdisciplinary practices in endocrinology, cardiovascular and metabolic risk, aging research, obesity, traditional medicine, pychosomatic research, behavioral medicine, ethics and evidence-based practices.As of Jan 2018 the journal is published by Springer as a hybrid journal with no article processing charges. All articles published before 2018 are available free of charge on springerlink.Unofficial 2017 2-year Impact Factor: 1.816.
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