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The Correlation between Time in Range and Diabetic Microvascular Complications Utilizing Information Management Platform
- Source :
- International Journal of Endocrinology, International Journal of Endocrinology, Vol 2020 (2020)
- Publication Year :
- 2020
- Publisher :
- Hindawi Limited, 2020.
-
Abstract
- Background. In recent years, the time of blood glucose within the target range is a new research hotspot in blood glucose management. TIR is expected to be a novel indicator for evaluating the efficacy of glycemic control and predicting diabetic complications. However, its relationship with diabetic complications has not been fully elucidated. Objective. To explore the relationship between time in range (TIR) and glycosylated hemoglobin (HbA1C) through the information big data management platform. Possible association between TIR and diabetic microvascular complications (retinopathy, nephropathy, and neuropathy) was investigated, attempting to provide theoretical basis for the clinical application of TIR and to explore the TIR control scope suitable for diabetic patients. Methods. A total of 5,644 type 2 diabetic patients hospitalized in the Department of Endocrinology, the Second Affiliated Hospital of Nanchang University, were selected from April 2017 to June 2020. Fingertip capillary blood glucose monitoring (FCGM) was monitored for a total of 455,664 times, and patients who are nondiabetic, pregnant, or with diabetic ketosis were excluded. Patients with 7 blood glucose points monitored for at least three consecutive days were selected as subjects in the study. 1,895 males and 1,513 females with diabetes were included, with an average age of (59.74 ± 13.40) years old and an average course of disease of 8.28 ± 7.11 years. The proportion of time in range (TIR) (70∼180 mg/dl) within the target range and the correlation between TIR and HbA1C were analyzed, as well as the relationship between TIR and the risk of diabetic complications. Results. (1) The average of TIR and HbA1C was 49.65 ± 23.36% and 8.92 ± 2.49%, respectively, and was linearly correlated. With the decrease of TIR, HbA1C increased significantly, and the difference was statistically significant ( P < 0.01 , R2 = 0.458). The correlation coefficient of mean TIR with mean HbA1C was −0.626. (2) There were 836 patients diagnosed with diabetic nephropathy (DN). The difference of TIR value between DN and non-DN was significant (T = 2.250, P < 0.05 ). Risk assessment showed the lower the TIR was, the higher the risk of DN was. TIR less than 40% was a risk factor for DN (OR = 1.249, 95% CI: 0.915–1.375). (3) There were 1,296 patients diagnosed with diabetic peripheral neuropathy (DPN). The difference of TIR value between DPN and non-DPN was significant (T = 3.844, P < 0.01 ). TIR value less than 70% was a risk factor for DPN (OR = 1.030, 95% CI: 0.769–1.379). (4) There were 2,077 patients diagnosed with diabetic retinopathy (DR). The difference of TIR value between DPN and non-DPN was significant (T = 3.608, P < 0.01 ). TIR value less than 50% was a risk factor for DR (OR = 1.092, 95% CI: 0.898–1.264). Summary. TIR may serve as a reference index for short-term blood glucose control, strongly reflecting the clinical blood glucose regulation and predicting the risk of diabetic microvascular complications.
- Subjects :
- medicine.medical_specialty
Article Subject
Endocrinology, Diabetes and Metabolism
030209 endocrinology & metabolism
digestive system
Gastroenterology
Diseases of the endocrine glands. Clinical endocrinology
Nephropathy
Diabetic nephropathy
03 medical and health sciences
0302 clinical medicine
Endocrinology
Diabetes mellitus
Internal medicine
parasitic diseases
0502 economics and business
medicine
Glycemic
Blood glucose monitoring
medicine.diagnostic_test
Endocrine and Autonomic Systems
business.industry
05 social sciences
Diabetic retinopathy
biochemical phenomena, metabolism, and nutrition
RC648-665
medicine.disease
Peripheral neuropathy
050211 marketing
business
Research Article
Retinopathy
Subjects
Details
- ISSN :
- 16878345 and 16878337
- Volume :
- 2020
- Database :
- OpenAIRE
- Journal :
- International Journal of Endocrinology
- Accession number :
- edsair.doi.dedup.....8a6b72b189709ae9cdd65ff0e66e505e