Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Relationship between glycaemic variability and hyperglycaemic clamp-derived functional variables in (impending) type 1 diabetes
Diabetologia, Volume 58, No. 12, Year 2015
Notification
URL copied to clipboard!
Description
Aims/hypothesis: We examined whether measures of glycaemic variability (GV), assessed by continuous glucose monitoring (CGM) and self-monitoring of blood glucose (SMBG), can complement or replace measures of beta cell function and insulin action in detecting the progression of preclinical disease to type 1 diabetes. Methods: Twenty-two autoantibody-positive (autoAb+) first-degree relatives (FDRs) of patients with type 1 diabetes who were themselves at high 5-year risk (50%) for type 1 diabetes underwent CGM, a hyperglycaemic clamp test and OGTT, and were followed for up to 31 months. Clamp variables were used to estimate beta cell function (first-phase [AUC5–10 min] and second-phase [AUC120–150 min] C-peptide release) combined with insulin resistance (glucose disposal rate; M120–150 min). Age-matched healthy volunteers (n = 20) and individuals with recent-onset type 1 diabetes (n = 9) served as control groups. Results: In autoAb+ FDRs, M120–150 min below the 10th percentile (P10) of controls achieved 86% diagnostic efficiency in discriminating between normoglycaemic FDRs and individuals with (impending) dysglycaemia. M120–150 min outperformed AUC5–10 min and AUC120–150 min C-peptide below P10 of controls, which were only 59–68% effective. Among GV variables, CGM above the reference range was better at detecting (impending) dysglycaemia than elevated SMBG (77–82% vs 73% efficiency). Combined CGM measures were equally efficient as M120–150 min (86%). Daytime GV variables were inversely correlated with clamp variables, and more strongly with M120–150 min than with AUC5–10 min or AUC120–150 min C-peptide. Conclusions/interpretation: CGM-derived GV and the glucose disposal rate, reflecting both insulin secretion and action, outperformed SMBG and first- or second-phase AUC C-peptide in identifying FDRs with (impending) dysglycaemia or diabetes. Our results indicate the feasibility of developing minimally invasive CGM-based criteria for close metabolic monitoring and as outcome measures in trials. © 2015, Springer-Verlag Berlin Heidelberg.
Authors & Co-Authors
Balti Vounsia, Eric
Belgium, Brussels
Vrije Universiteit Brussel
Weets, Ilse
Belgium, Brussels
Vrije Universiteit Brussel
Belgium, Jette
Universitair Ziekenhuis Brussel
De Block, Christophe E.M.
Belgium, Edegem
Universitair Ziekenhuis Antwerpen
Ruige, Johannes B.
Belgium, Ghent
Universitair Ziekenhuis Gent
Keymeulen, Bart
Belgium, Brussels
Vrije Universiteit Brussel
Belgium, Jette
Universitair Ziekenhuis Brussel
Pipeleers, Daniël G.
Belgium, Brussels
Vrije Universiteit Brussel
Gorus, Frans K.
Belgium, Brussels
Vrije Universiteit Brussel
Belgium, Jette
Universitair Ziekenhuis Brussel
Statistics
Citations: 13
Authors: 7
Affiliations: 5
Identifiers
Doi:
10.1007/s00125-015-3761-y
ISSN:
0012186X
Research Areas
Noncommunicable Diseases