Predictive Value of Blood Glucose Range for Onset of Complications in Patients with Diabetes Mellitus Type 1

Open access

Abstract

Background and aims: to develop a prognostic mathematical model for risk of microangiopathy in patients with diabetes mellitus type 1 (T1DM). Materials and methods: 62 T1DM patients were divided into 2 groups according to НвА1с level: group 1 (n=18) with НвА1с ≤ 7.0% and group 2 (n=44) with НвА1с > of 7.0%. HbA1c, Cpeptide, blood creatinine, estimated glomerular filtration rate (eGFR) CKD-EPI, first morning urinary albumin excretion (AU) were determined. Blood glucose levels were conducted by CGMS (Continuous Glucose Monitoring System). All patients were followed for 3 months. Rank correlation method was used. Results: We established the direct correlation between HbA1c the AU level ρ=0.29 (р<0.016) at the beginning and ρ=0.4 (р=0.021) after 3 months. AU level has a direct correlation with blood glucose range, at the beginning ρ=0.51 (р<0.001) and after 3 months ρ=0.48 (р=0.004) visits. We made the mathematical description of this dependence. Each additional unit of blood glucose range is accompanied by increasing an average level AU level by 0.4816 mg/l. Conclusion: our mathematical equation of dependence between AU level and blood glucose range gives the opportunities to predict diabetic kidney disease progression in T1DM patients.

1. World Health Organization. Diabetes Key facts. Accessed at: http://www.who.int/ru/news-room/factsheets/detail/diabetes

2. International Diabetes Federation. IDF Diabetes Atlas. 8th Edition 2017. Accessed at: http://diabetesatlas.org/IDF_Diabetes_Atlas_8e_interactive_EN

3. American Diabetes Association. Diabetes Basics. Available from: http://www.diabetes.org/diabetesbasics/type-1/?loc=util-header_type1

4. Saberzadeh-Ardestani B, Karamzadeh R, Basiri M, et al. Type 1 diabetes mellitus: cellular and molecular pathophysiology at A Glance. Cell J 20(3): 294-301, 2018.

5. Kitada M, Zhang Z, Mima A, King GL. Molecular mechanisms of diabetic vascular complications. J Diabetes Investig 1(3): 77-89.

6. Barrett EJ, Liu Z, Khamaisi M, et al. Diabetic Microvascular Disease: An Endocrine Society Scientific Statement. J Clin Endocrinol Metab 102(12): 4343-410, 2017.

7. Khalil H. Diabetes microvascular complications- A clinical update. Diabetes Metab Syndr Suppl 1: S133-S139, 2017

8. American Diabetes Association. Standards of Medical Care in Diabetes-2016. Diabetes Care 39(Suppl. 1): 13-22, 2016.

9. Nakaz MOZ Ukrainy vid 29.12.2014 N 1021. Unifikovanyi klinichnyi protokol pervynnoi, ekstrenoi, vtorynnoi (specializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomogy. Tsukrovyi diabet 1 typu u molodyh liudej ta doroslyh. Kyiv; 2014, available at: http://mtd.dec.gov.ua/images/dodatki/2014_1021_CD1_dor/2014_1021_YKPMD_CD1_dor.pdf

10. Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329(14): 977-86, 1993.

11. de Boer IH, DCCT/EDIC Research Group. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30 Years: Overview. Diabetes Care 37(1): 24-30, 2014.

12. DCCT/EDIC Research Group, Aiello LP, Sun W, et al. Intensive diabetes therapy and ocular surgery in type 1 diabetes. N Engl J Med 372(18): 1722-33, 2015.

13. Kilpatrick ES, Rigby AS, Atkin SL. A1C variability and the risk of microvascular complications in type 1 diabetes: data from the Diabetes Control and Complications Trial. Diabetes Care 31(11): 2198-202, 2008.

14. Lachin JM, Bebu I, Bergenstal RM, et al. Association of Glycemic Variability in Type 1 Diabetes With Progression of Microvascular Outcomes in the Diabetes Control and Complications Trial. Diabetes Care 40(6): 777-783, 2017.

15. Prázný M, Škrha J, Šoupal J, Škrha JJr. Glycemic variability and microvascular complications of diabetes. Cas Lek Cesk 156(6): 308-313, 2017.

16. Smith-Palmer J, Brändle M, Trevisan R, Orsini Federici M, Liabat S, Valentine W. Assessment of the association between glycemic variability and diabetes-related complications in type 1 and type 2 diabetes. Diabetes Res Clin Pract 105(3): 273-84, 2014

17. Hoffman RP, Dye AS, Huang H, Bauer JA. Effects of glucose control and variability on endothelial function and repair in adolescents with type 1 diabetes. ISRN Endocrinol 2013: 876547: 7, 2013.

18. Service FJ. Glucose variability. Diabetes 62(5): 1398-404, 2013.

Romanian Journal of Diabetes Nutrition and Metabolic Diseases

The Journal of Romanian Society of Diabetes Nutrition and Metabolic Diseases

Journal Information


CiteScore 2017: 0.11

SCImago Journal Rank (SJR) 2017: 0.122
Source Normalized Impact per Paper (SNIP) 2017: 0.077

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 37 37 14
PDF Downloads 35 35 8