Clinical and metabolic parameters associated with time in ranges and glucose variability in patients with type 2 diabetes treated with insulin

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Julia F. Semenova¹, Maksim V. Dashkin², Olga N. Fazullina^3
1Laboratory of Endocrinology Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences(RICEL – Branch of IC&G SB RAS) Novosibirsk, Russia, ekmxtyjr@yandex.ru
²Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences (RICEL – Branch of IC&G SB RAS) Novosibirsk, Russia, mdashkin@invitro.ru
³Laboratory of Endocrinology Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences(RICEL – Branch of IC&G SB RAS) Novosibirsk, Russia, fazullina@ngs.ru

Background and aim: Continuous glucose monitoring (CGM) provides an excellent opportunity for in-depth assessment of glycemic control and glucose variability (GV) in diabetic subjects. The aim of our study was to determine the clinical and metabolic parameters associated with non-targeted time in range (TIR) increased GV in patients with type 2 diabetes (T2D) treated with insulin.В Materials and Methods: One hundred and thirty six insulin-treated patients with T2D were included. Real-time or blinded CGM was performed using Medtronic CGM devices. The TIR and Mean Amplitude of Glucose Excursion (MAGE) were estimated. The advance glycation end-products (AGEs) levels were measured in blood serum by ELISA.В Results: Patients with non-targeted TIR (>70%) had higher glycated hemoglobin HbA1c, triglycerides and proteinuria as compared to those with targeted TIR. Urinary albumin-to-creatinine ratio tended to be higher in patients with non-targeted TIR also. Patients with higher MAGE (>4.5 mmol/l) demonstrated lower levels of triglycerides and uric acid and increased AGEs levels as compared to those with MAGE <4.5 mmol/l.В Conclusions: In T2D subjects, non-targeted TIR is associated with hypertriglyceridemia and proteinuria, meantime, increased MAGE is related to lower serum levels of triglycerides and uric acid and higher levels of AGEs.