The lack of long-range negative correlations in glucose dynamics is associated with worse glucose control in patients with diabetes mellitus

• Published in: Metabolism, clinical and experimental clinical and experimental, 2012-07, Vol.61 (7), p.1041-1050
• Main Authors: Ogata, Hitomi, Tokuyama, Kumpei, Nagasaka, Shoichiro, Tsuchita, Takeshi, Kusaka, Ikuyo, Ishibashi, Shun, Suzuki, Hiroaki, Yamada, Nobuhiro, Hamano, Kumiko, Kiyono, Ken, Struzik, Zbigniew R, Yamamoto, Yoshiharu
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood Glucose - analysis; Blood Glucose - metabolism; C-Peptide - urine; Deoxyglucose - blood; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Glycated Hemoglobin A - analysis; Humans; Hypoglycemic Agents - therapeutic use; Insulin - therapeutic use; Male; Medical sciences; Middle Aged; Serum Albumin - analysis; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2011.12.007

Abstract Glucose dynamics measured in ambulatory settings are fluid in nature and exhibit substantial complexity. We recently showed that a long-range negative correlation of glucose dynamics, which is considered to reflect blood glucose controllability over a substantial period, is absent in patients with diabetes mellitus. This was demonstrated using detrended fluctuation analysis (DFA), a modified random-walk analysis method for the detection of long-range correlations. In the present study, we further assessed the relationships between the established clinical indices of glycemic or insulinogenic control of hemoglobin A1c (HbA1c ), glycated albumin (GA), 1,5-anhydroglucitol, and urine C-peptide immunoreactivity and the recently proposed DFA-based indices obtained from continuous glucose monitoring in 104 Japanese diabetic patients. Significant correlations between the following parameters were observed: (1) HbA1c and the long-range scaling exponent α2 ( r = 0.236, P < .05), (2) GA and α2 ( r = 0.254, P < .05), (3) GA and the short-range scaling exponent α1 ( r = 0.233, P < .05), and (4) urine C-peptide immunoreactivity and the mean glucose fluctuations ( r = −0.294, P < .01). Therefore, we concluded that increases in the long-range DFA scaling exponent, which are indicative of the lack of a long-range negative correlation in glucose dynamics, reflected abnormalities in average glycemic control as clinically determined using HbA1c and GA parameters.