Residual β-Cell Function Is Associated With Longer Time in Range in Individuals With Type 1 Diabetes
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Residual β-Cell Function Is Associated With Longer Time in Range in Individuals With Type 1 Diabetes. / Snethlage, Coco M. Fuhri; McDonald, Timothy J.; Oram, Richard D.; de Groen, Pleun; Rampanelli, Elena; Schimmel, Alinda W. M.; Holleman, Frits; Siegelaar, Sarah; Hoekstra, Joost; Brouwer, Catherine B.; Knop, Filip K.; Verchere, C. Bruce; van Raalte, Daniël H.; Roep, Bart O.; Nieuwdorp, Max; Hanssen, Nordin M. J.
In: Diabetes Care, Vol. 47, No. 7, 2024, p. 1114-1121.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Residual β-Cell Function Is Associated With Longer Time in Range in Individuals With Type 1 Diabetes
AU - Snethlage, Coco M. Fuhri
AU - McDonald, Timothy J.
AU - Oram, Richard D.
AU - de Groen, Pleun
AU - Rampanelli, Elena
AU - Schimmel, Alinda W. M.
AU - Holleman, Frits
AU - Siegelaar, Sarah
AU - Hoekstra, Joost
AU - Brouwer, Catherine B.
AU - Knop, Filip K.
AU - Verchere, C. Bruce
AU - van Raalte, Daniël H.
AU - Roep, Bart O.
AU - Nieuwdorp, Max
AU - Hanssen, Nordin M. J.
N1 - © 2023 by the American Diabetes Association.
PY - 2024
Y1 - 2024
N2 - OBJECTIVE: Little is known about the influence of residual islet function on glycemic control in type 1 diabetes (T1D). We investigated the associations between residual β-cell function and metrics of continuous glucose monitoring (CGM) in individuals with T1D.RESEARCH DESIGN AND METHODS: In this cross-sectional cohort comprising 489 individuals (64% female, age 41.0 ± 14.0 years), T1D duration was 15.0 (interquartile range [IQR] 6.0-29.0) years. Individuals had a time in range (TIR) of 66% (IQR 52-80%) and a urinary C-peptide-to-creatinine ratio (UCPCR) of 0.01 (IQR 0.00-0.41) nmol/mmol. To assess β-cell function, we measured UCPCR (detectable >0.01 nmol/mmol), and to assess α-cell function, fasting plasma glucagon/glucose ratios were measured. CGM was used to record TIR (3.9-10 mmol/L), time below range (TBR) (<3.9 mmol/L), time above range (TAR) (>10 mmol/L), and glucose coefficient of variance (CV). For CGM, 74.7% used FreeStyle Libre 2, 13.8% Medtronic Guardian, and 11.5% Dexcom G6 as their device.RESULTS: The percentage of patients with T1D who had a detectable UCPCR was 49.4%. A higher UCPCR correlated with higher TIR (r = 0.330, P < 0.05), lower TBR (r = -0.237, P < 0.05), lower TAR (r = -0.302, P < 0.05), and lower glucose CV (r = -0.356, P < 0.05). A higher UCPCR correlated negatively with HbA1c levels (r = -0.183, P < 0.05) and total daily insulin dose (r = -0.183, P < 0.05). Glucagon/glucose ratios correlated with longer TIR (r = 0.234, P < 0.05).CONCLUSIONS: Significantly longer TIR, shorter TBR and TAR, and lower CV were observed in individuals with greater UCPCR-assessed β-cell function. Therefore, better CGM-derived metrics in individuals with preserved β-cell function may be a contributor to a lower risk of developing long-term complications.
AB - OBJECTIVE: Little is known about the influence of residual islet function on glycemic control in type 1 diabetes (T1D). We investigated the associations between residual β-cell function and metrics of continuous glucose monitoring (CGM) in individuals with T1D.RESEARCH DESIGN AND METHODS: In this cross-sectional cohort comprising 489 individuals (64% female, age 41.0 ± 14.0 years), T1D duration was 15.0 (interquartile range [IQR] 6.0-29.0) years. Individuals had a time in range (TIR) of 66% (IQR 52-80%) and a urinary C-peptide-to-creatinine ratio (UCPCR) of 0.01 (IQR 0.00-0.41) nmol/mmol. To assess β-cell function, we measured UCPCR (detectable >0.01 nmol/mmol), and to assess α-cell function, fasting plasma glucagon/glucose ratios were measured. CGM was used to record TIR (3.9-10 mmol/L), time below range (TBR) (<3.9 mmol/L), time above range (TAR) (>10 mmol/L), and glucose coefficient of variance (CV). For CGM, 74.7% used FreeStyle Libre 2, 13.8% Medtronic Guardian, and 11.5% Dexcom G6 as their device.RESULTS: The percentage of patients with T1D who had a detectable UCPCR was 49.4%. A higher UCPCR correlated with higher TIR (r = 0.330, P < 0.05), lower TBR (r = -0.237, P < 0.05), lower TAR (r = -0.302, P < 0.05), and lower glucose CV (r = -0.356, P < 0.05). A higher UCPCR correlated negatively with HbA1c levels (r = -0.183, P < 0.05) and total daily insulin dose (r = -0.183, P < 0.05). Glucagon/glucose ratios correlated with longer TIR (r = 0.234, P < 0.05).CONCLUSIONS: Significantly longer TIR, shorter TBR and TAR, and lower CV were observed in individuals with greater UCPCR-assessed β-cell function. Therefore, better CGM-derived metrics in individuals with preserved β-cell function may be a contributor to a lower risk of developing long-term complications.
U2 - 10.2337/dc23-0776
DO - 10.2337/dc23-0776
M3 - Journal article
C2 - 37535870
VL - 47
SP - 1114
EP - 1121
JO - Diabetes Care
JF - Diabetes Care
SN - 1935-5548
IS - 7
ER -
ID: 393848728