The northeast glucose drift: Stratification of post-breakfast dysglycemia among predominantly Hispanic/Latino adults at-risk or with type 2 diabetes.
The northeast glucose drift: Stratification of post-breakfast dysglycemia among predominantly Hispanic/Latino adults at-risk or with type 2 diabetes.
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DOI：
10.1016/j.eclinm.2021.101241
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发表时间：
2022-01
影响因子：
15.1
通讯作者：
Kerr D
中科院分区：
文献类型：
--
作者：
Barua S;Sabharwal A;Glantz N;Conneely C;Larez A;Bevier W;Kerr D
在缺乏服务的患有或有患2型糖尿病(T2D)风险的种族/少数民族人群中，连续血糖监测(CGM)的经验很少，因此缺乏对这些人的CGM驱动的洞察力。我们分析了自由生活，主要是西班牙裔/拉丁裔，有T2D风险，有T2D前或非胰岛素治疗T2D风险的自由生活的CGM资料。从2019年2月开始，美国加利福尼亚州圣巴巴拉的119名参与者(93名女性，87%西班牙裔/拉丁裔[主要是墨西哥裔美国人]，年龄54·4[±12·1]岁)，按HbA1c水平分为(I)T2D风险组，(Ii)T2D前期组，(Iii)非胰岛素治疗T2D组，为期两周。我们使用四个参数比较了这些参与者中106人的有效CGM曲线，这些曲线代表了早餐对葡萄糖的反应。与T2D前和T2D前的高危参与者相比，在早餐血糖反应中观察到了“东北漂移”。与T2D前和高危参与者相比，T2D参与者早餐前血糖水平、血糖升高、曲线下葡萄糖增量面积(P均<0.0001)和血糖达峰时间(P<0.05)均显著高于T2D前和高危参与者。在调整人口统计学和临床协变量后，早餐前血糖和达到峰值的时间(P<0.0001)与糖化血红蛋白显著相关。该模型预测的HbA1c在实验室HbA1c真实值的(0·550·67)%以内。对于以西班牙裔/拉丁裔为主的成年人来说，平均两周的早餐血糖反应显示出血糖紊乱的进展，从T2D风险到T2D前期再到T2D。以CGM为基础的早餐指标有可能预测HbA1c水平并监测糖尿病的进展。美国农业部(资助金#2018年-33800-28404)、美国国家科学基金会精密先进技术和医疗系统工程研究中心(PATH-UP)(1648451年奖)以及爱思唯尔基金会的种子资助金。
There is minimal experience in continuous glucose monitoring (CGM) among underserved racial/ethnic minority populations with or at risk of type 2 diabetes (T2D), and therefore a lack of CGM-driven insight for these individuals. We analyzed breakfast-related CGM profiles of free-living, predominantly Hispanic/Latino individuals at-risk of T2D, with pre-T2D, or with non-insulin treated T2D. Starting February 2019, 119 participants in Santa Barbara, CA, USA, (93 female, 87% Hispanic/Latino [predominantly Mexican-American], age 54·4 [±12·1] years), stratified by HbA1c levels into (i) at-risk of T2D, (ii) with pre-T2D, and (iii) with non-insulin treated T2D, wore blinded CGMs for two weeks. We compared valid CGM profiles from 106 of these participants representing glucose response to breakfast using four parameters. A “northeast drift” was observed in breakfast glucose responses comparing at-risk to pre-T2D to T2D participants. T2D participants had a significantly higher pre-breakfast glucose level, glucose rise, glucose incremental area under the curve (all p < 0·0001), and time to glucose peak (p < 0·05) compared to pre-T2D and at-risk participants. After adjusting for demographic and clinical covariates, pre-breakfast glucose and time to peak (p < 0·0001) were significantly associated with HbA1c. The model predicted HbA1c within (0·550·67)% of true laboratory HbA1c values. For predominantly Hispanic/Latino adults, the average two-week breakfast glucose response shows a progression of dysglycemia from at-risk of T2D to pre-T2D to T2D. CGM-based breakfast metrics have the potential to predict HbA1c levels and monitor diabetes progression. US Department of Agriculture (Grant #2018–33800–28404), a seed grant from the industry board fees of the NSF Engineering Research Center for Precise Advanced Technologies and Health Systems for Underserved Populations (PATHS-UP) (Award #1648451), and the Elsevier foundation.
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影响因子：
120.7
作者：
Cheng, Yiling J.;Kanaya, Alka M.;Imperatore, Giuseppina
通讯作者：
Imperatore, Giuseppina
影响因子：
2
作者：
Barua S;Solis L;Parra ER;Uraoka N;Jiang M;Wang H;Rodriguez-Canales J;Wistuba I;Maitra A;Sen S;Rao A
通讯作者：
Rao A
影响因子：
4.1
作者：
Bittel AJ;Bittel DC;Mittendorfer B;Patterson BW;Okunade AL;Abumrad NA;Reeds DN;Cade WT
通讯作者：
Cade WT
影响因子：
16.2
作者：
Hanefeld, M;Koehler, C;Temelkova-Kurktschiev, T
通讯作者：
Temelkova-Kurktschiev, T
影响因子：
5.6
作者：
Jakubowicz, Daniela;Wainstein, Julio;Froy, Oren
通讯作者：
Froy, Oren