Relationship between blood glucose variability in ambulatory glucose profile and standardized continuous glucose monitoring metrics: Subanalysis of a prospective cohort study

Abstract

Aim: To clarify the relationship between ambulatory glucose profile (AGP) indexes and standardized continuous glucose monitoring (CGM) metrics in patients with type 2 diabetes (T2D).Methods: This is an exploratory, cross-sectional analysis of baseline data collected from a prospective, multicentre, 5-year follow-up observational study conducted and published previously by our group. The study participants were 999 outpatients with T2D who used CGM at baseline, and had no apparent history of cardiovascular disease. We investigated the relationship between average interquartile range (IQR) and time in range (TIR). We also calculated, for the first time, the cutoff values to achieve the TIR target values.Results: In both the TIR more than 70% and TIR more than 90% achievement groups, the average IQR was notably small compared with the non-achievement groups.Particularly in comparison of the TIR quartiles, the average IQR became significantly smaller as the TIR became larger. The average IQR correlated negatively with TIR, and the cutoff values for TIR of more than 70% achievement and TIR of more than 90% achievement were an average IQR (>70%/>90%) of 2.13/1.85 mmol/L. Yosuke Okada and Tomoya Mita contributed equally to this study.

The Importance of Continuous Glucose Monitoring-derived Metrics Beyond HbA1c for Optimal Individualized Glycemic Control

“…The FreeStyle Libre Pro (FLP) (Abbott Japan, Tokyo, Japan) CGM (FLP-CGM) device, which measures glucose levels every 15 minutes for up to 14 days, was used as previously reported ( 15 , 17-19 ). Other than wearing the FLP-CGM, there were no restrictions on participants’ daily lives.…”

Glycemic variability: Measurement, target, impact on complications of diabetes and does it really matter?

“…Tokutsu et al . 21 found that an average IQR cutoff of 2.13 mmol/L achieved TIR >70%, whereas 1.85 mmol/L resulted in TIR >90%.…”

“…Ambulatory glucose profile condenses CGM data into a 24‐h representation, and IQR, represented by the 25th to 75th percentile trend lines on ambulatory glucose profile, serves as a powerful visual tool for assessing GV 19,20 . Additionally, robust correlations exist between average IQR and within‐day GV metrics, including SD and CV, as well as interday variations 21 . A significant IQR warrants an exploration of the factors influencing both interday and intraday GV in clinical settings.…”

“…A significant IQR warrants an exploration of the factors influencing both interday and intraday GV in clinical settings. Tokutsu et al 21 . found that an average IQR cutoff of 2.13 mmol/L achieved TIR >70%, whereas 1.85 mmol/L resulted in TIR >90%.…”