Impaired insulin secretion predicting unstable glycemic variability and time below range in type 2 diabetes patients regardless of glycated hemoglobin or diabetes treatment

Miya, Aika; Nakamura, Akinobu; Handa, Takahisa; Nomoto, Hiroshi; Kameda, Hiraku; Cho, Kyu Yong; Nagai, So; Miyoshi, Hideaki; Atsumi, Tatsuya

Impaired insulin secretion predicting unstable glycemic variability and time below range in type 2 diabetes patients regardless of glycated hemoglobin or diabetes treatment

Miya, Aika; Nakamura, Akinobu; Handa, Takahisa et al.

Journal of diabetes investigation, 2021, 12(5), 738-746

Permalink : https://hdl.handle.net/2115/81130

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アクセス権	open access
URI	https://hdl.handle.net/2115/81130
タイトル	Impaired insulin secretion predicting unstable glycemic variability and time below range in type 2 diabetes patients regardless of glycated hemoglobin or diabetes treatment
著者	Miya, Aika ; Nakamura, Akinobu ; Handa, Takahisa ; Nomoto, Hiroshi ; Kameda, Hiraku ; Cho, Kyu Yong ; Nagai, So ; Miyoshi, Hideaki ; Atsumi, Tatsuya
著者名 Miya, Aika
e-Rad_Researcher 70552420 著者名 Nakamura, Akinobu
著者名 Handa, Takahisa
e-Rad_Researcher 50862330 著者名 Nomoto, Hiroshi
e-Rad_Researcher 20826127 著者名 Kameda, Hiraku
著者名 Cho, Kyu Yong
e-Rad_Researcher 70507590 著者名 Nagai, So
e-Rad_Researcher 30360902 著者名 Miyoshi, Hideaki
e-Rad_Researcher 20301905 著者名 Atsumi, Tatsuya
言語	英語
キーワード	Glucose variability
	Hypoglycemia
	Insulin secretion
発行日	2021-05
出版者	John Wiley & Sons
収録物名	Journal of diabetes investigation
巻(号)	12(5)
ページ	738-746
抄録	Aims/Introduction To identify the coefficient of variation (CV) threshold for unstable glucose variability (GV) and hypoglycemia, and to characterize a patient population with unstable GV and hypoglycemia. Materials and Methods This was an observational study that enrolled 284 Japanese outpatients with type 2 diabetes who underwent continuous glucose monitoring. The C-peptide index (CPI = [(fasting serum C-peptide) / (plasma glucose)] x 100) was used as a marker of endogenous insulin secretion. The CV threshold between stable and unstable GV was defined as the upper limit of the CV distribution in the subgroup of patients who did not receive insulin nor insulin secretagogues (relatively stable GV subgroup, n = 104). The optimal CV range corresponding to time below target range >= 4% was determined for all patients using receiver operating characteristic curve analysis. Various characteristics of patients with unstable GV and hypoglycemia were extracted using multivariate logistic regression analysis. Results The upper limit of the CV in the relatively stable GV subgroup was 40. The optimal CV range corresponding to time below target range >= 4% was also defined as CV >= 40 (area under the curve 0.85) for all patients. The CPI was an independent risk for CV >= 40 (odds ratio 0.17, 95% confidence interval 0.04-0.50, P < 0.01). The optimal cut-off point for CPI to predict a CV cut-off value of 40 was equivalent to 0.81 (area under the curve 0.80). Conclusions A CV of 40 discriminates unstable GV and hypoglycemia from stable GV in Japanese outpatients with type 2 diabetes. Impaired insulin secretion might affect the stability of GV.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial 4.0 International
PISSN	2040-1116
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1111/jdi.13426