TY - JOUR
T1 - Dysglycemia in adults at risk for or living with non-insulin treated type 2 diabetes
T2 - Insights from continuous glucose monitoring
AU - Barua, Souptik
AU - Sabharwal, Ashutosh
AU - Glantz, Namino
AU - Conneely, Casey
AU - Larez, Arianna
AU - Bevier, Wendy
AU - Kerr, David
N1 - Funding Information:
Funding for the study was provided by the US Department of Agriculture (Grant number: 2018-33800-28404) and the NSF Engineering Research Center for Precise Advanced Technologies and Health Systems for Underserved Populations (PATHS-UP) (Award number 1648451). We would also like to acknowledge funding support from the Hearst Foundation, the Mosher Foundation, Sun Life Financial, the St. Francis Foundation and the Blooming Prairie Foundation.
Funding Information:
DK reports non-financial support from Abbott Diabetes Care, during the conduct of the study; grants from Lilly, personal fees from Sanofi, personal fees from NovoNordisk, personal fees from Glooko, outside the submitted work. NG, CC, AL, and WB report non-financial support from Abbott Diabetes Care, grants from US Dept of Agriculture, during the conduct of the study; grants from Lilly, outside the submitted work. SB and AS declare no competing interest(s).
Publisher Copyright:
© 2021 The Authors
PY - 2021/5
Y1 - 2021/5
N2 - Background: Continuous glucose monitoring (CGM) has demonstrable benefits for people living with diabetes, but the supporting evidence is almost exclusively from White individuals with type 1 diabetes. Here, we have quantified CGM profiles in Hispanic/Latino adults with or at-risk of non-insulin treated type 2 diabetes (T2D). Methods: 100 participants (79 female, 86% Hispanic/Latino [predominantly Mexican], age 54·6 [±12·0] years) stratified into (i) at risk of T2D, (ii) with pre-diabetes (pre-T2D), and (iii) with non-insulin treated T2D, wore blinded CGMs for 2 weeks. Beyond standardized CGM measures (average glucose, glucose variability, time in 70–140 mg/dL and 70–180 mg/dL ranges), we also examined additional CGM measures based on the time of day. Findings: Standardized CGM measures were significantly different for participants with T2D compared to at-risk and pre-T2D participants (p<0·0001). In addition, pre-T2D participants spent more time between 140 and 180 mg/dL during the day than at-risk participants (p<0·01). T2D participants spent more time between 140 and 180 mg/dL both during the day and overnight compared to at-risk and pre-T2D participants (both p<0·0001). Time in 70–140 mg/dL range during the day was significantly correlated with HbA1c (r=-0·72, p<0·0001), after adjusting for age, sex, BMI, and waist circumference (p<0·0001). Interpretation: Standardized CGM measures show a progression of dysglycemia from at-risk of T2D, to pre-T2D, and to T2D. Stratifying CGM readings by time of day and the range 140–180 mg/dL provides additional metrics to differentiate between the groups. Funding: US Department of Agriculture (Grant #2018-33800-28404) and NSF PATHS-UP ERC (Award #1648451).
AB - Background: Continuous glucose monitoring (CGM) has demonstrable benefits for people living with diabetes, but the supporting evidence is almost exclusively from White individuals with type 1 diabetes. Here, we have quantified CGM profiles in Hispanic/Latino adults with or at-risk of non-insulin treated type 2 diabetes (T2D). Methods: 100 participants (79 female, 86% Hispanic/Latino [predominantly Mexican], age 54·6 [±12·0] years) stratified into (i) at risk of T2D, (ii) with pre-diabetes (pre-T2D), and (iii) with non-insulin treated T2D, wore blinded CGMs for 2 weeks. Beyond standardized CGM measures (average glucose, glucose variability, time in 70–140 mg/dL and 70–180 mg/dL ranges), we also examined additional CGM measures based on the time of day. Findings: Standardized CGM measures were significantly different for participants with T2D compared to at-risk and pre-T2D participants (p<0·0001). In addition, pre-T2D participants spent more time between 140 and 180 mg/dL during the day than at-risk participants (p<0·01). T2D participants spent more time between 140 and 180 mg/dL both during the day and overnight compared to at-risk and pre-T2D participants (both p<0·0001). Time in 70–140 mg/dL range during the day was significantly correlated with HbA1c (r=-0·72, p<0·0001), after adjusting for age, sex, BMI, and waist circumference (p<0·0001). Interpretation: Standardized CGM measures show a progression of dysglycemia from at-risk of T2D, to pre-T2D, and to T2D. Stratifying CGM readings by time of day and the range 140–180 mg/dL provides additional metrics to differentiate between the groups. Funding: US Department of Agriculture (Grant #2018-33800-28404) and NSF PATHS-UP ERC (Award #1648451).
KW - Continuous glucose monitoring
KW - Hispanic/Latino adults
KW - Pre-diabetes
KW - Time in range
KW - Type 2 diabetes
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U2 - 10.1016/j.eclinm.2021.100853
DO - 10.1016/j.eclinm.2021.100853
M3 - Article
AN - SCOPUS:85104823528
SN - 2589-5370
VL - 35
JO - EClinicalMedicine
JF - EClinicalMedicine
M1 - 100853
ER -