New insights from continuous glucose monitoring into the route to diabetes

• Published in: Diabetes/metabolism research and reviews 2018-07, Vol.34 (5), p.e3002-n/a
• Main Authors: Colas, Ana, Vigil, Luis, Rodríguez de Castro, Carmen, Vargas, Borja, Varela, Manuel
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers - blood; Blood Glucose - analysis; Blood Glucose Self-Monitoring - methods; continuous glucose monitoring system; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - etiology; diabetes risk development; Fasting; Female; Follow-Up Studies; Glucose; Glucose Intolerance - blood; Glucose Intolerance - diagnosis; Glucose Intolerance - etiology; Glucose monitoring; Glucose tolerance; Humans; Hypertension - complications; impaired fasting glucose; impaired glucose tolerance; Laboratory testing; Male; Middle Aged; Phenotypes; Phenotyping; Prediabetic State - blood; Prediabetic State - diagnosis; Prediabetic State - etiology; Prognosis; Survival analysis; Survival Rate; Young Adult
• ISSN: 1520-7552; 1520-7560
• DOI: 10.1002/dmrr.3002

Aim Type 2 diabetes mellitus (T2DM) is preceded by a period of impaired glucoregulation. We investigated if continuous glucose monitoring system (CGMS) (1) could improve our capacity to predict the development of T2DM in subjects at risk. (2) Find out if impaired fasting glucose/impaired glucose tolerance differentiation through CGMS would also elucidate differences in clinical phenotypes. Material and methods Observational study of 209 hypertensive patients, aged 18 to 85 years who wore at entry a CGMS. Two CGMS metrics, percent of time under the 100 mg/dL glycaemic threshold (TU100) (impaired fasting glucose surrogate phenotype) and area above the 140 mg/dL glycemic threshold (AO140) (impaired glucose tolerance surrogate phenotype) were measured. The median follow‐up was 32 months (6‐72 mo), and there were 17 new cases of T2DM. Results In a multivariate Cox proportional hazard survival analysis including the conventional prediabetes‐defining criteria and the 2 CGMS‐derived variables, only TU100 and HbA1c were significant and independent variables in predicting T2DM development. An increase in 0.1 in TU100 resulted in a 0.69 (95% CI, 0.54‐0.88; P