Association of point in range with β-cell function and insulin sensitivity of type 2 diabetes mellitus in cold areas-Reference-Cited by-同舟云学术

Association of point in range with β-cell function and insulin sensitivity of type 2 diabetes mellitus in cold areas

Published:2023-12-01 Issue:4 Volume:3 Page:242-252
ISSN:2719-8073
Container-title:Frigid Zone Medicine
language:en
Short-container-title:

Author:

Ni Yanan¹,Liu Dan²,Zhang Xiaona¹,Qiao Hong¹

Affiliation:

1. 1 Department of Endocrinology, NO.2 Affiliated Hospital of Harbin Medical University , Harbin , China

2. 2 Department of Biostatistics, Harbin Medical University , Harbin , China

Abstract

Abstract Background and Objective Self-monitoring of blood glucose (SMBG) is crucial for achieving a glycemic target and upholding blood glucose stability, both of which are the primary purpose of anti-diabetic treatments. However, the association between time in range (TIR), as assessed by SMBG, and β-cell insulin secretion as well as insulin sensitivity remains unexplored. Therefore, this study aims to investigate the connections between TIR, derived from SMBG, and indices representing β-cell functionality and insulin sensitivity. The primary objective of this study was to elucidate the relationship between short-term glycemic control (measured as points in range [PIR]) and both β-cell function and insulin sensitivity. Methods This cross-sectional study enrolled 472 hospitalized patients with type 2 diabetes mellitus (T2DM). To assess β-cell secretion capacity, we employed the insulin secretion-sensitivity index-2 (ISSI-2) and (ΔC-peptide0–120/Δglucose0–120) × Matsuda index, while insulin sensitivity was evaluated using the Matsuda index and HOMA-IR. Since SMBG offers glucose data at specific point-in-time, we substituted TIR with PIR. According to clinical guidelines, values falling within the range of 3.9–10 mmol were considered “in range, ” and the corresponding percentage was calculated as PIR. Results We observed significant associations between higher PIR quartiles and increased ISSI-2, (ΔC-peptide0–120/Δglucose0–120) × Matsuda index, Matsuda index (increased) and HOMA-IR (decreased) (all P < 0.001). PIR exhibited positive correlations with log ISSI-2 (r = 0.361, P < 0.001), log (ΔC-peptide0–120/Δglucose0–120) × Matsuda index (r = 0.482, P < 0.001), and log Matsuda index (r = 0.178, P < 0.001) and negative correlations with log HOMA-IR (r = -0.288, P < 0.001). Furthermore, PIR emerged as an independent risk factor for log ISSI-2, log (ΔC-peptide0–120/Δglucose0–120) × Matsuda index, log Matsuda index, and log HOMA-IR. Conclusion PIR can serve as a valuable tool for assessing β-cell function and insulin sensitivity.

Publisher

Walter de Gruyter GmbH

Link

https://www.sciendo.com/pdf/10.2478/fzm-2023-0031

Reference47 articles.

1. Porte D. β-cells in type II diabetes mellitus. Diabetes, 1991; 40(2): 166–180.

2. Defronzo R A. Lilly lecture 1987. The triumvirate: Beta-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes, 1988; 37(6): 667-687.

3. Stratton I M, Adler A I, Neil H A, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ, 2000; 321(7258): 405–412.

4. Kramer C K, Choi H, Zinman B, et al. Glycemic variability in patients with early type 2 diabetes: the impact of improvement in β-cell function. Diabetes Care, 2014; 37(4): 1116–1123.

5. Liu L, Liu J, Xu L, et al. Lower mean blood glucose during short-term intensive insulin therapy is associated with long-term glycemic remission in patients with newly diagnosed type 2 diabetes: Evidence-based recommendations for standardization. J Diabetes Investig, 2018; 9(4): 908–916.