Time in range, assessed with continuous glucose monitoring, is associated with brachial-ankle pulse wave velocity in type 2 diabetes: A retrospective single-center analysis

Aims The aim of this retrospective single-center is to research the relationship between time in range(TIR), an important novel metric of glycemic control, assessed with continuous glucose monitoring(CGM) and brachial-ankle pulse wave velocity(BaPWV), a unique index of systemic arterial stiffness in type 2 diabetes. Methods Study participants included 469 hospitalized patients with type 2 diabetes and no history of serious cardiovascular disease who underwent CGM and BaPWV measurements. TIR of 3.9-10.0 mmol/L was evaluated with CGM. BaPWV was measured by non-invasive arteriosclerosis detector and high baPWV was defined as a mean baPWV≧1800m/s. The spearman correlation and the partial correlation analysis were applied to analyze the correlation between TIR and baPWV. The binary logistic regression was used to examine the independent association of TIR and high BaPWV. Results The presence of high baPWV was 32.2%. Compared with patients of low baPWV, those with high baPWV had significantly reduced TIR(P<0.001). With the increase of TIR tertiles, the prevalence of high BaPWV progressively decreased. Correlation analysis showed that TIR is inversely correlated with BaPWV. In a fully adjusted model controlling for traditional risk factor of CVD, TIR is associated with the presence of high BaPWV independent of HbA1c. Conclusion TIR is correlated with BaPWV independent of HbA1c in patients with type 2 diabetes, confirming a link between TIR and arterial stiffness.

[1]  Xia Sheng,et al.  The Correlation between Time in Range and Diabetic Microvascular Complications Utilizing Information Management Platform , 2020, International journal of endocrinology.

[2]  G. Hu,et al.  Time in Range in Relation to All-Cause and Cardiovascular Mortality in Patients With Type 2 Diabetes: A Prospective Cohort Study , 2020, Diabetes Care.

[3]  Y. Bao,et al.  Time in range is associated with carotid intima-media thickness in type 2 diabetes. , 2020, Diabetes technology & therapeutics.

[4]  6. Glycemic Targets: Standards of Medical Care in Diabetes—2020 , 2019, Diabetes Care.

[5]  Chantal M. Mcmahon,et al.  The Relationship of Hemoglobin A1C to Time-in-Range in Patients with Diabetes. , 2019, Diabetes technology & therapeutics.

[6]  R. Beck,et al.  Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials , 2018, Diabetes Care.

[7]  Y. Bao,et al.  Association of Time in Range, as Assessed by Continuous Glucose Monitoring, With Diabetic Retinopathy in Type 2 Diabetes , 2018, Diabetes Care.

[8]  M. Miyata.  Noninvasive Assessment of Arterial Stiffness Using Oscillometric Methods: baPWV, CAVI, API, and AVI , 2018, Journal of atherosclerosis and thrombosis.

[9]  J. Shaw,et al.  IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. , 2018, Diabetes research and clinical practice.

[10]  Eyal Dassau,et al.  International Consensus on Use of Continuous Glucose Monitoring , 2017, Diabetes Care.

[11]  B. Zinman,et al.  Day-to-day fasting glycaemic variability in DEVOTE: associations with severe hypoglycaemia and cardiovascular outcomes (DEVOTE 2) , 2017, Diabetologia.

[12]  Roy W Beck,et al.  The Fallacy of Average: How Using HbA1c Alone to Assess Glycemic Control Can Be Misleading , 2017, Diabetes Care.

[13]  T. Nakayama,et al.  Causes of death in Japanese patients with diabetes based on the results of a survey of 45,708 cases during 2001–2010: Report of the Committee on Causes of Death in Diabetes Mellitus , 2017, Journal of diabetes investigation.

[14]  Laura Lovato,et al.  Effects of High Density Lipoprotein Raising Therapies on Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus, with or without Renal Impairment: The Action to Control Cardiovascular Risk in Diabetes Study , 2016, American Journal of Nephrology.

[15]  P. Conlin,et al.  Identifying the independent effect of HbA1c variability on adverse health outcomes in patients with Type 2 diabetes , 2016, Diabetic medicine : a journal of the British Diabetic Association.

[16]  A. Goldfine,et al.  Clinical Update: Cardiovascular Disease in Diabetes Mellitus Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus – Mechanisms, Management, and Clinical Considerations , 2016, Circulation.

[17]  K. Dhatariya,et al.  The effect of anaemia and abnormalities of erythrocyte indices on HbA1c analysis: a systematic review , 2015, Diabetologia.

[18]  S. Prenner,et al.  Arterial stiffness in diabetes mellitus. , 2015, Atherosclerosis.

[19]  R. Takayanagi,et al.  Brachial-Ankle Pulse Wave Velocity Predicts All-Cause Mortality and Cardiovascular Events in Patients With Diabetes: The Kyushu Prevention Study of Atherosclerosis , 2014, Diabetes Care.

[20]  M. Woodward,et al.  Impact of Visit-to-Visit Glycemic Variability on the Risks of Macrovascular and Microvascular Events and All-Cause Mortality in Type 2 Diabetes: The ADVANCE Trial , 2014, Diabetes Care.

[21]  N. Hamajima,et al.  The relationship of brachial-ankle pulse wave velocity to future cardiovascular disease events in the general Japanese population: the Takashima Study , 2014, Journal of Human Hypertension.

[22]  J. Shaw,et al.  Global estimates of diabetes prevalence for 2013 and projections for 2035. , 2014, Diabetes Research and Clinical Practice.

[23]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[24]  Vilmundur Gudnason,et al.  Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death , 2011 .

[25]  R. Casamitjana,et al.  Repeated Episodes of Hypoglycemia as a Potential Aggravating Factor for Preclinical Atherosclerosis in Subjects With Type 1 Diabetes , 2010, Diabetes Care.

[26]  Y. Iwamoto,et al.  Causes of death in Japanese diabetics: A questionnaire survey of 18,385 diabetics over a 10‐year period , 2010, Journal of diabetes investigation.

[27]  W. Herman.  Do Race and Ethnicity Impact Hemoglobin A1c Independent of Glycemia? , 2009, Journal of diabetes science and technology.

[28]  Grant D. Huang,et al.  Glucose control and vascular complications in veterans with type 2 diabetes. , 2009, The New England journal of medicine.

[29]  R. Roeder,et al.  Transient high glucose causes persistent epigenetic changes and altered gene expression during subsequent normoglycemia , 2008, The Journal of Experimental Medicine.

[30]  Diederick Grobbee,et al.  Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. , 2008, The New England journal of medicine.

[31]  Michael E. Miller,et al.  Effects of intensive glucose lowering in type 2 diabetes. , 2008, The New England journal of medicine.

[32]  R. Testa,et al.  Oscillating Glucose Is More Deleterious to Endothelial Function and Oxidative Stress Than Mean Glucose in Normal and Type 2 Diabetic Patients , 2008, Diabetes.

[33]  J. Bottomley,et al.  Economic costs of diabetes in the US in 2007 — Implications for Europe , 2008 .

[34]  F. T. E. Group,et al.  Relationship of elevated casual blood glucose level with coronary heart disease, cardiovascular disease and all-cause mortality in a representative sample of the Japanese population. NIPPON DATA80 , 2008, Diabetologia.

[35]  Haiqing Gao,et al.  Correlation between Brachial-Ankle Pulse Wave Velocity and Arterial Compliance and Cardiovascular Risk Factors in Elderly Patients with Arteriosclerosis , 2006, Hypertension Research.

[36]  Jean-Paul Cristol,et al.  Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. , 2006, JAMA.

[37]  Michael Brownlee,et al.  The pathobiology of diabetic complications: a unifying mechanism. , 2005, Diabetes.

[38]  D. Kass,et al.  Mechanisms, pathophysiology, and therapy of arterial stiffness. , 2005, Arteriosclerosis, thrombosis, and vascular biology.

[39]  Plamen Nikolov,et al.  Economic Costs of Diabetes in the U.S. in 2002 , 2003, Diabetes care.

[40]  R. Holman,et al.  Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study , 2000, BMJ : British Medical Journal.

[41]  Marta Elena Losa-Iglesias,et al.  Footwear used by older people and a history of hyperkeratotic lesions on the foot , 2017, Medicine.

[42]  J. Ahmad,et al.  HbA1c in pregnancy. , 2012, Diabetes & metabolic syndrome.

[43]  V. Preedy,et al.  Prospective Cohort Study , 2010 .

[44]  S. Schinner.  Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes , 2009 .

[45]  L. Ruilope,et al.  The ADVANCE Trial , 2009, American journal of cardiovascular drugs : drugs, devices, and other interventions.

[46]  R. Zimlichman,,et al.  Arterial Elasticity in Cardiovascular Disease: Focus on Hypertension, Metabolic Syndrome and Diabetes , 2008 .

[47]  No Authors.  Standards of Medical Care in Diabetes — 2021 , 2022, KIDNEYS.