학술논문
Cross-sectional association of continuous glucose monitoring-derived metrics with cerebral small vessel disease in older adults with type 2 diabetes.
Document Type
Academic Journal
Author
Sugimoto T; Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Department of Medicine, University of Washington, Seattle, Washington, USA.; Saji N; Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.; Omura T; Department of Metabolic Research, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Department of Endocrinology and Metabolism, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.; Tokuda H; Department of Metabolic Research, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Department of Endocrinology and Metabolism, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.; Department of Clinical Laboratory, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.; Miura H; Department of Endocrinology and Metabolism, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.; Department of Home Care and Regional Liaison Promotion, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.; Kawashima S; Department of Endocrinology and Metabolism, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.; Ando T; Information Technology and Human Factors, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan.; Nakamura A; Department of Biomarker Research, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Uchida K; Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan.; Matsumoto N; Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Fujita K; Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Kuroda Y; Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Crane PK; Department of Medicine, University of Washington, Seattle, Washington, USA.; Sakurai T; Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.; Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan.; Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.
Source
Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 100883645 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1463-1326 (Electronic) Linking ISSN: 14628902 NLM ISO Abbreviation: Diabetes Obes Metab Subsets: MEDLINE
Subject
Language
English
Abstract
Aim: To examine cross-sectional associations between continuous glucose monitoring (CGM)-derived metrics and cerebral small vessel disease (SVD) in older adults with type 2 diabetes.
Materials and Methods: In total, 80 patients with type 2 diabetes aged ≥70 years were analysed. Participants underwent CGM for 14 days. From the CGM data, we derived mean sensor glucose, percentage glucose coefficient of variation, mean amplitude of glucose excursion, time in range (TIR, 70-180 mg/dl), time above range (TAR) and time below range metrics, glycaemia risk index and high/low blood glucose index. The presence of cerebral SVD, including lacunes, microbleeds, enlarged perivascular spaces and white matter hyperintensities, was assessed, and the total number of these findings comprised the total cerebral SVD score (0-4). Ordinal logistic regression analyses were performed to examine the association of CGM-derived metrics with the total SVD score.
Results: The median SVD score was 1 (interquartile range 0-2). Higher hyperglycaemic metrics, including mean sensor glucose, TAR >180 mg/dl, TAR >250 mg/dl, and high blood glucose index and glycaemia risk index, were associated with a higher total SVD score. In contrast, a higher TIR (per 10% increase) was associated with a lower total SVD score (odds ratio 0.73, 95% confidence interval 0.56-0.95). Glycated haemoglobin, percentage glucose coefficient of variation, mean amplitude of glucose excursions, time below range and low blood glucose index were not associated with total cerebral SVD scores.
Conclusions: The hyperglycaemia metrics and TIR, derived from CGM, were associated with cerebral SVD in older adults with type 2 diabetes.
(© 2024 John Wiley & Sons Ltd.)
Materials and Methods: In total, 80 patients with type 2 diabetes aged ≥70 years were analysed. Participants underwent CGM for 14 days. From the CGM data, we derived mean sensor glucose, percentage glucose coefficient of variation, mean amplitude of glucose excursion, time in range (TIR, 70-180 mg/dl), time above range (TAR) and time below range metrics, glycaemia risk index and high/low blood glucose index. The presence of cerebral SVD, including lacunes, microbleeds, enlarged perivascular spaces and white matter hyperintensities, was assessed, and the total number of these findings comprised the total cerebral SVD score (0-4). Ordinal logistic regression analyses were performed to examine the association of CGM-derived metrics with the total SVD score.
Results: The median SVD score was 1 (interquartile range 0-2). Higher hyperglycaemic metrics, including mean sensor glucose, TAR >180 mg/dl, TAR >250 mg/dl, and high blood glucose index and glycaemia risk index, were associated with a higher total SVD score. In contrast, a higher TIR (per 10% increase) was associated with a lower total SVD score (odds ratio 0.73, 95% confidence interval 0.56-0.95). Glycated haemoglobin, percentage glucose coefficient of variation, mean amplitude of glucose excursions, time below range and low blood glucose index were not associated with total cerebral SVD scores.
Conclusions: The hyperglycaemia metrics and TIR, derived from CGM, were associated with cerebral SVD in older adults with type 2 diabetes.
(© 2024 John Wiley & Sons Ltd.)