Assessment of glucose variability in subjects with prediabetes

Chakarova, Nevena; Dimova, Rumyana; Grozeva, Greta; Tankova, Tsvetalina

doi:10.1016/j.diabres.2019.03.038

Cited by 37 publications

(25 citation statements)

References 28 publications

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“…24 GV seems to be an important marker in addition to OGTT and HbA1c to evaluate glycemia in prediabetes. 18 Literature data have shown its importance for the overall cardio-metabolic risk independently of glucose tolerance. 29 Thus, our findings confirm the risk profile of the prediabetes state.…”

Section: Discussionmentioning

confidence: 99%

“…There is a significant reciprocal correlation between sympathetic and parasympathetic activity and measurements of both mean levels of glycemia, including glycated hemoglobin, estimated average glucose, glucose management index, and mean interstitial glucose; and most of the GV indices, including CONGA1, JINDEX, LI, LBGI, MAG, and M-Value in the studied cohort ( Table 2). Both sympathetic and parasympathetic tone are independently related to JINDEX in the whole cohort (F[1, 66] = 5.30, p = 0.025), and in prediabetes (F[1, 47] = 5.76, p = 0.021 for the sympathetic activity and F[1, 47] = 5.94, p = 0.019 for the parasympathetic activity); and to time above target range in NGT (F[1, 18] = 4.48, p = 0.049 for the sympathetic activity and F [1,18] = 4.65, p = 0.046 for the parasympathetic activity). The multiple correlation coefficients showed that about 11% of the variance of both sympathetic and parasympathetic tone might be accounted for by JINDEX in prediabetes and approximately 21% of the variance of cardiac autonomic function -by time above target range in NGT (Table 2).…”

Section: Relationship Between Parameters Of Cardiac Autonomic Functiomentioning

confidence: 99%

“…17 Data on GV in subjects with early alterations of glycemia have shown that worsening of glucose tolerance is related not only to an increase in mean glucose levels, but also to higher GV indices. 18 These results raise the question of the potential contribution of GV to the development of cardiac autonomic dysfunction and the increased cardiovascular risk in this population. 19,20…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the relationship between cardiac autonomic function and glucose variability and HOMA-IR in prediabetes

Dimova

Chakarova

Grozeva

et al. 2020

Diabetes and Vascular Disease Research

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Aims: The present study aims to investigate the relationship between cardiac autonomic function (CAF) and glucose variability (GV) and HOMA-IR in subjects with prediabetes and normal glucose tolerance (NGT). Material and methods: Ninety-two subjects (59 with prediabetes and 33 with NGT), of mean age 50.3 ± 11.5 years, mean BMI 30.4 ± 6.0 kg/m2, were included in this cross-sectional study. Glucose tolerance was assessed by OGTT according to WHO 2006 criteria. Glucose, HbA1c, insulin, oxLDL, and 3-Nitrotyrosine were measured. CGM was performed with a blinded sensor (FreeStyle Libre Pro). CAF was assessed by ANX-3.0 technology. Results: GV indices were increased in prediabetes. CAF was suppressed in subjects with any stage of dysglycemia. The prevalence of cardiac autonomic dysfunction was higher in prediabetes −20.3% as compared to NGT −3.0%, p = 0.028. HOMA-IR [OR 1.5 (95% CI: 1.1–2.1), p = 0.010] and time in target range [OR 0.8 (95% CI: 0.67–0.97), p = 0.021] were found to be predictive variables for impaired CAF. Sympathetic and parasympathetic activity negatively correlated with mean glycemia and GV indices and were independently related to JINDEX in prediabetes ( F[1, 47] = 5.76, p = 0.021 and F[1, 47] = 5.94, p = 0.019, respectively); and to time above target range in NGT ( F[1, 18] = 4.48, p = 0.049 and F[1, 18] = 4.65, p = 0.046, respectively). Conclusion: CAF is declined in prediabetes and seems to be related to GV and HOMA-IR at early stages of dysglycemia.

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Section: Discussionmentioning

confidence: 99%

Section: Relationship Between Parameters Of Cardiac Autonomic Functiomentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of the relationship between cardiac autonomic function and glucose variability and HOMA-IR in prediabetes

Dimova

Chakarova

Grozeva

et al. 2020

Diabetes and Vascular Disease Research

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“…15 Our study is the first to demonstrate that increased FPG variability in prepregnancy was associated with the risk of GDM in the primipara with normal fasting glucose level even after adjusting other risk factors. Although FPG variability is affected by the mean glucose level, 24 the association between FPG variability and GDM was consistent even after adjusting the mean FPG. Interestingly, the association of FPG variability was strengthened in insulin-treated GDM rather than in those without insulin treatment.…”

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confidence: 76%

Association of fasting plasma glucose variability with gestational diabetes mellitus: a nationwide population-based cohort study

Kim

Roh

et al. 2020

BMJ Open Diab Res Care

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ObjectiveLong-term glycemic variability has recently been recognized as another risk factor for future adverse health outcomes. We aimed to evaluate the risk of gestational diabetes mellitus (GDM) according to the prepregnancy long-term fasting plasma glucose (FPG) variability.Research design and methodsA total of 164 053 women who delivered their first baby between January 1, 2012 and December 31, 2015, were selected from the Korean National Health Insurance data. All women underwent at least three national health screening examinations, and the last examination should be conducted within 2 years before their first delivery. GDM was defined as the presence of more than four times of claim of GDM (International Classification of Disease, 10th Revision (ICD-10) O24.4 and O24.9) or prescription of insulin under the ICD-code of GDM. FPG variability was assessed by variability independent of the mean (FPG-VIM), coefficient of variation, SD, and average successive variability.ResultsAmong the 164 053 women, GDM developed in 6627 (4.04%). Those in the higher quartiles of FPG-VIM showed a stepwise increased risk of GDM. In fully adjusted model, the ORs for GDM was 1.22 (95% CI 1.14 to 1.31) in women with the highest FPG-VIM quartile compared with those in the lowest quartile. The risk for GDM requiring insulin therapy was 48% increase in women in the highest quartile of FPG-VIM compared with those in the lowest quartile, while that for GDM not requiring insulin therapy was 19% increase. The association between high FPG variability and the risk of GDM was intensified in the obese and aged more than 35 years women.ConclusionsIncreased FPG variability in the prepregnancy state is associated with the risk of GDM independent of confounding factors. Therefore, prepregnancy FPG variability might be a surrogate marker of the risk of GDM.

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Insulin secretion and action affect glucose variability in the early stages of glucose intolerance

Dimova

Chakarova

Daniele

et al. 2022

Diabetes Metabolism Res

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Aims: Since it is unknown whether glucose variability (GV) is increased and whether this is related to worsening of insulin secretion and action in prediabetes, we have assessed insulin secretion and sensitivity, and daily GV in early stages of dysglycemia. Materials and Methods: Twenty subjects with normal glucose tolerance (NGT; age 45.0 � 9.5 years; BMI 31.1 � 6.4 kg/m2), 25 with NGT and 1hrOGTT>8.6 mmol/L (1hrOGTT; 45.7 � 8.5 years; 32.4 � 7.0 kg/m2), and 59 with isolated impaired glucose tolerance (iIGT; 47.7 � 11.2 years; 31.3 � 6.1 kg/m2) underwent OGTT and MMTT. CGM was performed with blinded FreeStyle Libre Pro for 24 h under standard conditions. Parameters of beta-cell function, insulin sensitivity and GV were calculated.Results: Overall insulin secretion and action as well as GV progressively worsened across glucose tolerance categories. On a matrix analysis, GV parameters were inversely related to ISSI-2; r = −0.37 to −0.52; p < 0.0001; and IGI; r = −0.28 to −0.48; p < 0.0001 for CV, SD, J-index, LI, HBGI and MAGE. Insulin secretion (IGI) and b-cell function (ISSI-2) emerged as independent contributors to GV in early stage of dysglycemia accounting for about 16%-38% of its variability. Conclusions:Our results show that daily GV worsens already with mild impairment of glucose tolerance. The increase in GV is inversely related to insulin secretion and action.

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Assessment of glucose variability in subjects with prediabetes

Cited by 37 publications

References 28 publications

Evaluation of the relationship between cardiac autonomic function and glucose variability and HOMA-IR in prediabetes

Evaluation of the relationship between cardiac autonomic function and glucose variability and HOMA-IR in prediabetes

Association of fasting plasma glucose variability with gestational diabetes mellitus: a nationwide population-based cohort study

Insulin secretion and action affect glucose variability in the early stages of glucose intolerance

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