残留的β细胞功能与 1 型糖尿病患者较长的服药时间有关。

IF 14.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes Care Pub Date : 2024-07-01 DOI:10.2337/dc23-0776
Coco M Fuhri Snethlage, Timothy J McDonald, Richard D Oram, Pleun de Groen, Elena Rampanelli, Alinda W M Schimmel, Frits Holleman, Sarah Siegelaar, Joost Hoekstra, Catherine B Brouwer, Filip K Knop, C Bruce Verchere, Daniël H van Raalte, Bart O Roep, Max Nieuwdorp, Nordin M J Hanssen
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引用次数: 0

摘要

目的:人们对残余胰岛功能对 1 型糖尿病(T1D)患者血糖控制的影响知之甚少。我们调查了 T1D 患者的残余 β 细胞功能与连续血糖监测(CGM)指标之间的关系:在这一横断面队列中,共有 489 名患者(64% 为女性,年龄为 41.0 ± 14.0 岁),T1D 病程为 15.0 年(四分位数间距 [IQR] 6.0-29.0 年)。患者的血糖在正常范围内的时间(TIR)为 66%(IQR 52-80%),尿液中 C 肽与肌酐的比值(UCPCR)为 0.01(IQR 0.00-0.41) nmol/mmol。为评估 β 细胞功能,我们测量了 UCPCR(可检测到 >0.01 nmol/mmol);为评估 α 细胞功能,我们测量了空腹血浆胰高血糖素/葡萄糖比率。使用 CGM 记录 TIR(3.9-10 毫摩尔/升)、低于范围时间 (TBR) (10 毫摩尔/升)和葡萄糖方差系数 (CV)。在血糖仪方面,74.7%的患者使用 FreeStyle Libre 2,13.8%的患者使用 Medtronic Guardian,11.5%的患者使用 Dexcom G6:结果:可检测到 UCPCR 的 T1D 患者比例为 49.4%。较高的 UCPCR 与较高的 TIR(r = 0.330,P < 0.05)、较低的 TBR(r = -0.237,P < 0.05)、较低的 TAR(r = -0.302,P < 0.05)和较低的葡萄糖 CV(r = -0.356,P < 0.05)相关。较高的 UCPCR 与 HbA1c 水平(r = -0.183,P < 0.05)和每日胰岛素总剂量(r = -0.183,P < 0.05)呈负相关。胰高血糖素/葡萄糖比率与较长的TIR相关(r = 0.234,P < 0.05):结论:UCPCR 评估的 β 细胞功能越强,TIR 明显越长,TBR 和 TAR 越短,CV 越低。因此,β细胞功能保持较好的个体的 CGM 衍生指标可能有助于降低患长期并发症的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Residual β-Cell Function Is Associated With Longer Time in Range in Individuals With Type 1 Diabetes.

Objective: Little is known about the influence of residual islet function on glycemic control in type 1 diabetes (T1D). We investigated the associations between residual β-cell function and metrics of continuous glucose monitoring (CGM) in individuals with T1D.

Research design and methods: In this cross-sectional cohort comprising 489 individuals (64% female, age 41.0 ± 14.0 years), T1D duration was 15.0 (interquartile range [IQR] 6.0-29.0) years. Individuals had a time in range (TIR) of 66% (IQR 52-80%) and a urinary C-peptide-to-creatinine ratio (UCPCR) of 0.01 (IQR 0.00-0.41) nmol/mmol. To assess β-cell function, we measured UCPCR (detectable >0.01 nmol/mmol), and to assess α-cell function, fasting plasma glucagon/glucose ratios were measured. CGM was used to record TIR (3.9-10 mmol/L), time below range (TBR) (<3.9 mmol/L), time above range (TAR) (>10 mmol/L), and glucose coefficient of variance (CV). For CGM, 74.7% used FreeStyle Libre 2, 13.8% Medtronic Guardian, and 11.5% Dexcom G6 as their device.

Results: The percentage of patients with T1D who had a detectable UCPCR was 49.4%. A higher UCPCR correlated with higher TIR (r = 0.330, P < 0.05), lower TBR (r = -0.237, P < 0.05), lower TAR (r = -0.302, P < 0.05), and lower glucose CV (r = -0.356, P < 0.05). A higher UCPCR correlated negatively with HbA1c levels (r = -0.183, P < 0.05) and total daily insulin dose (r = -0.183, P < 0.05). Glucagon/glucose ratios correlated with longer TIR (r = 0.234, P < 0.05).

Conclusions: Significantly longer TIR, shorter TBR and TAR, and lower CV were observed in individuals with greater UCPCR-assessed β-cell function. Therefore, better CGM-derived metrics in individuals with preserved β-cell function may be a contributor to a lower risk of developing long-term complications.

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来源期刊
Diabetes Care
Diabetes Care 医学-内分泌学与代谢
CiteScore
27.80
自引率
4.90%
发文量
449
审稿时长
1 months
期刊介绍: The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.
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