Glucose time in range and peripheral neuropathy in type 2 diabetes mellitus and chronic kidney disease
| Autor: | Zona Batacchi, Iram Ahmad, Irl B. Hirsch, Nicole Robinson, Nisha Bansal, Dace L. Trence, Laura Mayeda, Leila R. Zelnick, Ronit Katz, Ian H. de Boer |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Renal function 030209 endocrinology & metabolism Diseases of the endocrine glands. Clinical endocrinology Nephropathy 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine medicine Humans 030212 general & internal medicine Prospective Studies Renal Insufficiency Chronic Pathophysiology/Complications Aged Glycated Hemoglobin diabetes business.industry Insulin Blood Glucose Self-Monitoring Type 2 Diabetes Mellitus Peripheral Nervous System Diseases Middle Aged medicine.disease RC648-665 Prognosis Diabetic foot 3. Good health glucose monitoring Peripheral neuropathy Diabetes Mellitus Type 2 Case-Control Studies nephropathy neuropathy Female business diabetic foot Biomarkers Kidney disease Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | BMJ Open Diabetes Research & Care BMJ Open Diabetes Research & Care, Vol 8, Iss 1 (2020) |
| ISSN: | 2052-4897 |
| Popis: | ObjectiveCompared with hemoglobin A1c (HbA1c), continuous glucose monitoring (CGM) may better capture risk of diabetes complications in patients with chronic kidney disease (CKD), including diabetic peripheral neuropathy (DPN). We hypothesized that glucose time in range (TIR), measured by CGM, is associated with DPN symptoms among participants with type 2 diabetes mellitus (type 2 DM) and moderate-to-severe CKD.Research design and methodsWe enrolled 105 people with type 2 DM treated with insulin or sulfonylurea, 81 participants with CKD (estimated glomerular filtration rate (eGFR) 2) and 24 matched control participants with eGFR ≥60 mL/min/1.73 m2. Each participant wore a CGM for two 6-day periods. Calculated glycemic measures included TIR (glucose 70–180 mg/dL) and glucose management indicator (GMI). DPN symptoms were assessed using the Michigan Neuropathy Screening Instrument (MNSI) questionnaire, with a positive MNSI score defined as ≥2 symptoms.ResultsParticipants with CKD had a mean age of 68 years, diabetes duration 20 years, eGFR 38 mL/min/1.73 m2 and HbA1c 7.8%, 61 mmol/mol. Sixty-two participants reported ≥2 DPN symptoms, 51 (63%) with CKD and 11 (46%) controls. Less TIR and higher GMI were associated with higher risk of MNSI questionnaire score ≥2 (OR 1.25 (95% CI 1.02 to 1.52) per 10% lower TIR, and OR 1.79 (95% CI 1.05 to 3.04) per 1% higher GMI, adjusting for age, gender and race). Similar results were observed when analyses were restricted to participants with CKD. In contrast, there was no significant association of HbA1c with DPN symptoms.ConclusionsSymptoms of DPN were common among participants with long-standing type 2 DM and CKD. Lower TIR and higher GMI were associated with DPN symptoms. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|