Introduction Preventing the development and progression of diabetic microvascular complications through optimal blood glucose control remains an important challenge. Whether metrics based on continuous glucose monitoring are useful for the management of diabetic microvascular complications is not entirely clear.
Research design and methods This is an exploratory analysis of an ongoing prospective, multicenter, 5-year follow-up observational study. Study participants included 999 outpatients with type 2 diabetes who underwent continuous glucose monitoring at baseline. Associations between continuous glucose monitoring-derived metrics and the severity of diabetic retinopathy or albuminuria were investigated using multivariable proportional odds models.
Results The overall prevalence of diabetic retinopathy was 22.2%. Multivariate analysis with proportional odds models demonstrated that continuous glucose monitoring-derived metrics related to intraday and interday glucose variability are significantly associated with the severity of diabetic retinopathy, even after adjusting for various possible risk factors. However, significant relationships were not observed after adjusting for hemoglobin A1c (HbA1c) levels. The prevalence of microalbuminuria and macroalbuminuria was 20.3% and 6.7%, respectively. Similarly, multivariate analysis demonstrated that those metrics are significantly associated with the severity of albuminuria. These relationships remained significant even after further adjusting for HbA1c levels.
Conclusions Continuous glucose monitoring-derived metrics related to intraday and interday glucose variability are significantly associated with the severity of diabetic retinopathy or albuminuria in patients with type 2 diabetes. Thus, evaluating these metrics might possibly be useful for risk assessment of diabetic microvascular complications.
Trial registration number UMIN000032325.
- diabetic retinopathy
Data availability statement
Data are available upon reasonable request. All data generated or analyzed during this study are included in this published article or in the data repositories listed in the References.
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Contributors All authors contributed to the study design and were involved in all stages of manuscript development. SW and TM drafted the manuscript. MG, a statistician, was primarily responsible for data analysis. SW, TM, NK, YO, TO, HY, KN, TS, KT, AK, MG, IS, and HW also collected, analyzed, and interpreted the data; reviewed and edited the manuscript; and approved the final manuscript. HW is the principal guarantor of this work; he has full access to all study data and takes responsibility for the integrity of the data and the accuracy of data analysis. All authors have read and agreed to the publication of the manuscript.
Funding This study was financially supported by the Japan Agency for Medical Research and Development (AMED) under Grant Number JP20ek0210105 (to HW) and the Manpei Suzuki Diabetes Foundation (to HW).
Competing interests TO and HW have received research funds from Abbott Japan. HW is a member of the advisory board of Abbott Japan. All other authors declare no conflicts of interest.
Provenance and peer review Not commissioned; externally peer reviewed.
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