Continuous glucose monitoring parameters in insulin-treated type 2 diabetic patients: relationships with obesity and body composition

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Julia F. Semenova¹, Olga N. Fazullina^2
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
²Laboratory 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: Obesity and associated insulin resistance can modify daily blood glucose fluctuations in patients with diabetes. The aim of our study was to determine the relationships between obesity, body composition and daily dynamics of glucose, assessed by continuous glucose monitoring (CGM), in patients with type 2 diabetes treated with insulin.
Materials and Methods: One hundred and thirty six insulin-treated patients with type 2 diabetes were examined. Real-time or blinded CGM was performed using Medtronic CGM devices in hospital settings. Time in ranges and a panel of GV parameters were derived from CGM recordings.
Results: Patients with obesity, as compared to those without, demonstrated significantly reduced Time Below Range (p<0.001), Low Blood Glucose Index (p<0.001), Lability Index (p=0.04), Men Absolute Glucose (p=0.03) and a tendency to lower Mean Amplidude of Glucose Excursions (p=0.08) and higher glycated hemoglobin HbA1c (p=0.07). There were negative correlations between total fat mass and Standard Deviation (r=-0.53, p=0.0008), Mean Amplitude of Glucose Excursions (r=-0.38, p=0.02), Lability Index (r=-0.51, p=0.0008), High Blood Glucose Index (r=-0.33, p=0.04) and MAG (r=-0.57, p=0.0001). Truncal fat mass, android and gynoid fat mass demonstrated negative correlations with these GV parameters also.
Conclusions: These data demonstrate the association between obesity, body composition and CGM parameters in insulin-treated type 2 diabetic subjects. The presence of obesity and accumulation of adipose tissue is associated with reduced GV and diminished risk of hypoglycemia.