Factors that determine glucose variability, defined by the coefficient of variation in continuous glucose monitoring values, in a Chinese population with type 2 diabetes.

Abstract

AIMS:

To elucidate the clinical determinants of the coefficient of variation (CV) of glucose by analysing the pancreatic β-cell function of subjects with type 2 diabetes mellitus (T2DM).

METHODS:

A total of 716 Chinese subjects with T2DM were included. Continuous glucose monitoring (CGM) was used to assess blood glucose, and the CV was calculated. C-peptide concentration at 0, 0.5, 1, 2 and 3 hours (Cp0h, Cp0.5h, Cp1h, Cp2h and Cp3h, respectively) was measured after a standard 100-g steamed bun meal test to assess pancreatic β-cell function. The determinants of glucose variability defined by the CV of CGM values were explored from two perspectives: the CV of qualitative variables and the CV of quantitative variables.

RESULTS:

Our data revealed that C-peptide concentration (Cp0h, Cp0.5h, Cp1h, Cp2h, Cp3h), area under the curve for C-peptide concentration at 0.5 and 3 hours (AUC-Cp0.5h and AUC-Cp3h) decreased with increasing CV quartile (P < 0.05). The CV was negatively correlated with homeostatic model assessment of β-cell function index, C-peptide concentration at all timepoints, and AUC-Cp0.5h and AUC-Cp3h (P < 0.001). Quantile regression analysis showed that AUC-Cp0.5h had an overall negative effect on the CV in the 0.05 to 0.95 quartiles, and AUC-Cp3h tended to have a negative effect on the CV in the 0.2 to 0.65 quartiles. After adjusting for confounders, multinomial logistic regression showed that each 1-unit increase in AUC-Cp0.5h was associated with a 31.7% reduction in the risk of unstable glucose homeostasis (CV > 36%; P = 0.036; odds ratio 0.683; 95% confidence interval 0.478-0.976). We also identified the AUC-Cp0.5h (0.735 ng/mL) and AUC-Cp3h (13.355 ng/mL) cut-off values for predicting unstable glucose homeostasis (CV >36%) in T2DM subjects.

CONCLUSION:

Our study suggests that impaired pancreatic β-cell function may be a clinical determining factor of CV of glucose in people with T2DM.

• Authors: Xi Wen, Huijun Yang, Man Yang, Wenyu Tao, Jiaoli Chen, Shanshan Zhao, Mingliu Yin, Xing Zhou, Ying Yang, Yiping Li
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 26 Issue 2 Pg. 611-621 (Feb 2024) ISSN: 1463-1326 [Electronic] England
• PMID: 37953677 (Publication Type: Journal Article)
• Copyright: © 2023 John Wiley & Sons Ltd.

Chemical References

• Blood Glucose
• Glucose
• C-Peptide

Topics

• Humans
• Diabetes Mellitus, Type 2 (complications)
• Blood Glucose (analysis)
• Glucose
• Blood Glucose Self-Monitoring
• C-Peptide
• Continuous Glucose Monitoring
• China (epidemiology)