CGM-measured glucose values have a strong correlation with C-peptide, HbA1c and IDAAC, but do poorly in predicting C-peptide levels in the two years following onset of diabetes
CGM-measured glucose values have a strong correlation with C-peptide, HbA1c and IDAAC, but do poorly in predicting C-peptide levels in the two years following onset of diabetes
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DOI：
10.1007/s00125-015-3559-y
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发表时间：
2015-06-01
期刊：
影响因子：
8.2
通讯作者：
Tamborlane, William
中科院分区：
文献类型：
--
作者：
Buckingham, Bruce;Cheng, Peiyao;Tamborlane, William
目的/假设这项工作的目的是评估 1 型糖尿病诊断后头 2 年内连续血糖监测 (CGM) 数据、HbA(1c)、胰岛素剂量调整 HbA(1c) (IDAA(1c)) 和 C 肽反应之间的关联。方法对一项随机试验收集的数据进行二次分析，该试验评估 1 型糖尿病诊断后 1 周内开始的强化管理的效果，其中在基线和 24 个月内的另外 8 个时间点进行了混合膳食耐受性测试。每次访视均收集 CGM 数据。 结果 在 67 名研究参与者（平均年龄 [+/- SD] 13.3 +/- 5.7 岁）中，每个时间点的 HbA(1c) 与 C 肽呈负相关 (p < 0.001)，时间点之间每项测量值的变化也是如此 (p < 0.001)。然而，一次就诊时的 C 肽并不能预测下一次就诊时 HbA(1c) 的变化，反之亦然。较高的 C 肽水平与 CGM 葡萄糖值在 3.9 至 7.8 mmol/l 之间的比例增加以及较低的 CV 相关（分别为 p = 0.001 和 p = 0.02），但与 CGM 葡萄糖水平 < 3.9 mmol/l 无关。事实上，所有 IDAA(1c) < 9 的参与者都保留了大量的胰岛素分泌，但与 CGM 一起评估时，3.9-7.8 mmol/l 范围内的时间和 CV 在预测 C 肽水平方面没有提供额外的价值。结论/解释 在诊断 1 型糖尿病后的前 2 年中，较高的 C 肽水平与目标范围内的传感器葡萄糖水平增加以及较低的葡萄糖变异性相关，但与低血糖无关。在预测 C 肽水平方面，CGM 指标无法提供比 IDAA(1c) 更高的附加值。
Aims/hypothesis The aim of this work was to assess the association between continuous glucose monitoring (CGM) data, HbA(1c), insulin-dose-adjusted HbA(1c) (IDAA(1c)) and C-peptide responses during the first 2 years following diagnosis of type 1 diabetes.Methods A secondary analysis was conducted of data collected from a randomised trial assessing the effect of intensive management initiated within 1 week of diagnosis of type 1 diabetes, in which mixed-meal tolerance tests were performed at baseline and at eight additional time points through 24 months. CGM data were collected at each visit.Results Among 67 study participants (mean age [+/- SD] 13.3 +/- 5.7 years), HbA(1c) was inversely correlated with C-peptide at each time point (p < 0.001), as were changes in each measure between time points (p < 0.001). However, C-peptide at one visit did not predict the change in HbA(1c) at the next visit and vice versa. Higher C-peptide levels correlated with increased proportion of CGM glucose values between 3.9 and 7.8 mmol/l and lower CV (p = 0.001 and p = 0.02, respectively) but not with CGM glucose levels < 3.9 mmol/l. Virtually all participants with IDAA(1c) < 9 retained substantial insulin secretion but when evaluated together with CGM, time in the range of 3.9-7.8 mmol/l and CV did not provide additional value in predicting C-peptide levels.Conclusions/interpretation In the first 2 years after diagnosis of type 1 diabetes, higher C-peptide levels are associated with increased sensor glucose levels in the target range and with lower glucose variability but not hypoglycaemia. CGM metrics do not provide added value over the IDAA(1c) in predicting C-peptide levels.