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Eaton M, Probst Y, Foster T, Messore J, Robinson L. A systematic review of observational studies exploring the relationship between health and non-weight-centric eating behaviours. Appetite 2024; 199:107361. [PMID: 38643903 DOI: 10.1016/j.appet.2024.107361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/22/2024] [Accepted: 04/13/2024] [Indexed: 04/23/2024]
Abstract
Eating behaviour that does not centralise weight, otherwise known as weight-neutral, is associated with improved physical and psychological health, and greater health promoting behaviours. However, consolidated evidence is lacking. This study aimed to systematically evaluate 'health-centric' eating behaviour reflective of weight-neutral approaches, and their relationship with health (physical and mental) and health promoting behaviours. A systematic search was performed, identifying observational studies with adult populations, ≥1 physical/mental health outcome(s), and ≥1 validated measure(s) of health-centric eating behaviour. Study design, sample characteristics and outcomes were extracted and characterised into four domains. Our search identified 8281 records, with 86 studies, 75 unique datasets, and 78 unique exposures including 94,710 individuals. Eating behaviours included intuitive eating (n = 48), mindful eating (n = 19), and eating competence (n = 11). There were 298 outcomes identified for body composition, size, and physical health (n = 116), mental health and wellbeing (n = 123), health promoting behaviours (n = 51) and other eating behaviour (n = 8). Higher levels of intuitive eating, mindful eating and eating competence were significantly related to a lower BMI, better diet quality and greater physical activity. Higher intuitive and mindful eating were significantly related to lower levels of disordered eating, and depressive symptoms, and greater body image, self-compassion, and mindfulness. Greater eating competence and intuitive eating were significantly related to higher fruit and vegetable intake, and greater eating competence to higher fibre intake and better sleep quality. Our results demonstrate that 'health-centric' eating behaviours are related to a range of favourable health outcomes and engagement in health promoting behaviours. These findings help to enhance our understanding of eating behaviours that do not centre around body weight, providing support for health-centric eating behaviour in healthcare. Future research should focus on intervention studies and more diverse population groups.
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Affiliation(s)
- Melissa Eaton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia.
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Tiarna Foster
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Julia Messore
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Laura Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia
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Savvopoulos S, Hatzikirou H, Jelinek HF. Comparative Analysis of Biomarkers in Type 2 Diabetes Patients With and Without Comorbidities: Insights Into the Role of Hypertension and Cardiovascular Disease. Biomark Insights 2024; 19:11772719231222111. [PMID: 38707193 PMCID: PMC11069335 DOI: 10.1177/11772719231222111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 12/04/2023] [Indexed: 05/07/2024] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) are 90% of diabetes cases, and its prevalence and incidence, including comorbidities, are rising worldwide. Clinically, diabetes and associated comorbidities are identified by biochemical and physical characteristics including glycemia, glycated hemoglobin (HbA1c), and tests for cardiovascular, eye and kidney disease. Objectives Diabetes may have a common etiology based on inflammation and oxidative stress that may provide additional information about disease progression and treatment options. Thus, identifying high-risk individuals can delay or prevent diabetes and its complications. Design In patients with or without hypertension and cardiovascular disease, as part of progression from no diabetes to T2DM, this research studied the changes in biomarkers between control and prediabetes, prediabetes to T2DM, and control to T2DM, and classified patients based on first-attendance data. Control patients and patients with hypertension, cardiovascular, and with both hypertension and cardiovascular diseases are 156, 148, 61, and 216, respectively. Methods Linear discriminant analysis is used for classification method and feature importance, This study examined the relationship between Humanin and mitochondrial protein (MOTSc), mitochondrial peptides associated with oxidative stress, diabetes progression, and associated complications. Results MOTSc, reduced glutathione and glutathione disulfide ratio (GSH/GSSG), interleukin-1β (IL-1β), and 8-isoprostane were significant (P < .05) for the transition from prediabetes to t2dm, highlighting importance of mitochondrial involvement. complement component 5a (c5a) is a biomarker associated with disease progression and comorbidities, gsh gssg, monocyte chemoattractant protein-1 (mcp-1), 8-isoprostane being most important biomarkers. Conclusions Comorbidities affect the hypothesized biomarkers as diabetes progresses. Mitochondrial oxidative stress indicators, coagulation, and inflammatory markers help assess diabetes disease development and provide appropriate medications. Future studies will examine longitudinal biomarker evolution.
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Affiliation(s)
- Symeon Savvopoulos
- Mathematics Department, Khalifa University, Abu Dhabi, United Arab Emirates
| | | | - Herbert F Jelinek
- Department of Biomedical Engineering and Health Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
- Biotechnology Center, Khalifa University, Abu Dhabi, United Arab Emirates
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Orešković D, Madero Pohlen A, Cvitković I, Alen JF, Raguž M, Álvarez-Sala de la Cuadra A, Bazarra Castro GJ, Bušić Z, Konstantinović I, Ledenko V, Martínez Macho C, Müller D, Žarak M, Jovanov-Milosevic N, Chudy D, Marinović T. Chronic hyperglycemia and intracranial meningiomas. BMC Cancer 2024; 24:488. [PMID: 38632533 PMCID: PMC11022447 DOI: 10.1186/s12885-024-12243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
Meningiomas are among the most common primary tumors of the central nervous system. Previous research into the meningioma histological appearance, genetic markers, transcriptome and epigenetic landscape has revealed that benign meningiomas significantly differ in their glucose metabolism compared to aggressive lesions. However, a correlation between the systemic glucose metabolism and the metabolism of the tumor hasn't yet been found. We hypothesized that chronic levels of glycaemia (approximated with glycated hemoglobin (HbA1c)) are different in patients with aggressive and benign meningiomas. The study encompassed 71 patients with de novo intracranial meningiomas, operated on in three European hospitals, two in Croatia and one in Spain. Our results show that patients with WHO grade 2 meningiomas had significantly higher HbA1c values compared to patients with grade 1 lesions (P = 0.0290). We also found a significant number of patients (19/71; 26.7%) being hyperglycemic, harboring all the risks that such a condition entails. Finally, we found a significant correlation between our patients' age and their preoperative HbA1c levels (P = 0.0008, ρ(rho) = 0.388), suggesting that older meningioma patients are at a higher risk of having their glycaemia severely dysregulated. These findings are especially important considering the current routine and wide-spread use of corticosteroids as anti-edematous treatment. Further research in this area could lead to better understanding of meningiomas and have immediate clinical impact.
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Affiliation(s)
- D Orešković
- Department of Neurosurgery, Clinical Hospital Dubrava, Zagreb, Croatia.
| | - A Madero Pohlen
- Department of Neurosurgery, University Hospital de la Princesa, Madrid, Spain
| | - I Cvitković
- Department of Neurosurgery, University Hospital Center Split, Split, Croatia
| | - J F Alen
- Department of Neurosurgery, University Hospital de la Princesa, Madrid, Spain
| | - M Raguž
- Department of Neurosurgery, Clinical Hospital Dubrava, Zagreb, Croatia
| | | | - G J Bazarra Castro
- Department of Neurosurgery, University Hospital de la Princesa, Madrid, Spain
| | - Z Bušić
- Department of Neurosurgery, University Hospital Center Split, Split, Croatia
| | - I Konstantinović
- Department of Neurosurgery, University Hospital Center Split, Split, Croatia
| | - V Ledenko
- Department of Neurosurgery, University Hospital Center Split, Split, Croatia
| | - C Martínez Macho
- Department of Neurosurgery, University Hospital de la Princesa, Madrid, Spain
| | - D Müller
- Department of Pathology, Clinical Hospital Dubrava, Zagreb, Croatia
| | - M Žarak
- Clinical Department of Laboratory Diagnostics, Clinical Hospital Dubrava, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - N Jovanov-Milosevic
- Department of Biology, School of Medicine, University of Zagreb, Zagreb, Croatia
- Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, School of Medicine, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia
| | - D Chudy
- Department of Neurosurgery, Clinical Hospital Dubrava, Zagreb, Croatia
- Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, School of Medicine, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia
| | - T Marinović
- Department of Neurosurgery, Clinical Hospital Dubrava, Zagreb, Croatia
- Department of Neurology and Neurosurgery, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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Friedman JG, Smith EP, Awasty SS, Behan M, Genco MT, Hempel H, Jafri S, Jandarov R, Nagaraj T, Franco RS, Cohen RM. Primary care diabetes assessment when HbA1c and other measures of glycemia disagree. Prim Care Diabetes 2024; 18:151-156. [PMID: 38172007 DOI: 10.1016/j.pcd.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/08/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
AIMS Although diabetes management decisions in primary care are typically based largely on HbA1c, mismatches between HbA1c and other measures of glycemia that are increasingly more available present challenges to optimal management. This study aimed to assess a systematic approach to identify the frequency of mismatches of potential clinical significance amongst various measures of glycemia in a primary care setting. METHODS Following screening to exclude conditions known to affect HbA1c interpretation, HbA1c, and fructosamine were obtained and repeated after ∼90 days on 53 adults with prediabetes or type 2 diabetes. A subset of 13 participants with repeat labs wore continuous glucose monitoring (CGM) for 10 days. RESULTS As expected, HbA1c and fructosamine only modestly correlated (initial R2 = 0.768/repeat R2 = 0.655). The HbA1c/fructosamine mismatch frequency of ± 0.5% (using the following regression HbA1c = 0.015 *fructosamine + 2.994 calculated from the initial sample) was 27.0%. Of the 13 participants with CGM data, HbA1c and CGM-based Glucose Management Indicator correlated at R2 = 0.786 with a mismatch frequency of ± 0.5% at 46.2% compared to a HbA1c/fructosamine mismatch frequency of ± 0.5% at 30.8%. CONCLUSIONS HbA1c is frequently mismatched with fructosamine and CGM data. As each of the measures has strengths and weaknesses, the utilization of multiple different measures of glycemia may be informative for diabetes assessment in the clinical setting.
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Affiliation(s)
- Jared G Friedman
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL USA.
| | - Eric P Smith
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sanjana S Awasty
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University College of Medicine, Columbus, OH, USA
| | | | - Matthew T Genco
- Division of Endocrinology, Diabetes, and Metabolism, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Cincinnati VA Medical Center, Cincinnati, OH, USA
| | - Hannah Hempel
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sabih Jafri
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Roman Jandarov
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Robert S Franco
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert M Cohen
- Division of Endocrinology, Diabetes, and Metabolism, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Cincinnati VA Medical Center, Cincinnati, OH, USA
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Zimu L, Mahomed O. Prevalence and determinants of poor glycaemic control in individuals aged between 18-60 years, at a regional hospital in KwaZulu-Natal Province, South Africa- a cross sectional study. Afr Health Sci 2023; 23:339-347. [PMID: 38974271 PMCID: PMC11225451 DOI: 10.4314/ahs.v23i4.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Background Achieving optimal blood glucose control is imperative for preventing diabetes related complications and negative socio-economic consequences associated with them. Objectives The aim of the study was to determine the prevalence and determinants of poor glycaemic control amongst type II diabetic outpatients presenting at a regional semi-rural hospital in eThekwini district, Kwa-Zulu Natal. Methods An observational, analytic cross-sectional study was conducted amongst 384 systematically sampled type 2 diabetes patients. Data were collected by an interviewer administered questionnaire, clinical record review and anthropometric measurements. Bivariate and multivariate analyses were performed. Results Ninety one percent of the study population (349/384) had poorly controlled diabetes. Amongst uncontrolled diabetics, 80% (n=281) were older than 35 years' age group; 58% (n= 203) were male; 85% (n=295) completed primary school education and 93% (n=324) were overweight. Patients that were 35 years and older, female, employed, had a high body mass index, were on oral hypoglycaemic and/or insulin in combination, and receiving treatment longer than 3 years, had an increased odd of uncontrolled diabetes. Being female and receiving oral hypoglycaemic and/or insulin were significantly associated with poor blood glucose control. Conclusion Patient that were female overweight, having a lower level of education, and greater than three-year duration of medication and on oral hypoglycaemic agent and/or insulin were more likely to have poor blood glucose control. These factors should serve as early identifiers of potential poor control and an alert clinician to adopt a more active approach to optimize treatment.
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Affiliation(s)
- Lindelwa Zimu
- University of KwaZulu-Natal College of Health Sciences, Public Health Medicine
| | - Ozayr Mahomed
- University of KwaZulu-Natal College of Health Sciences, Public Health Medicine
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Pulleyblank R, Larsen NB. Cost-Effectiveness of Semaglutide vs. Empagliflozin, Canagliflozin, and Sitagliptin for Treatment of Patients with Type 2 Diabetes in Denmark: A Decision-Analytic Modelling Study. PHARMACOECONOMICS - OPEN 2023:10.1007/s41669-023-00416-z. [PMID: 37178435 DOI: 10.1007/s41669-023-00416-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/10/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The aim was to evaluate the cost-effectiveness of oral and subcutaneous semaglutide versus other oral glucose-lowering drugs (i.e., empagliflozin, canagliflozin, and sitagliptin) for the management of type 2 diabetes (T2D) in Denmark using clinically relevant treatment intensification rules. METHODS A Markov-type cohort model for evaluating the cost-effectiveness of treatment pathways for T2D was used to produce cost-effectiveness estimates based on four head-to-head trials. Evidence from PIONEER 2 and 3 trials was used to evaluate the cost-effectiveness of oral semaglutide vs. empagliflozin and sitagliptin. Evidence from SUSTAIN 2 and 8 trials was used to evaluate the cost-effectiveness of subcutaneous semaglutide vs. sitagliptin and canagliflozin. Base case analyses used trial product estimands of treatment efficacy to avoid the confounding effects of rescue medication use during trials. Deterministic scenario analyses and probabilistic sensitivity analyses were conducted to assess robustness of cost-effectiveness estimates. RESULTS Semaglutide-based treatment regimens were consistently associated with higher lifetime diabetes treatment costs, lower costs of complications, and higher lifetime accumulated QALYs. The PIONEER 2 analysis estimated the cost-effectiveness of oral semaglutide vs. empagliflozin was DKK 150,618/QALY (€20,189). The PIONEER 3 analysis estimated the cost-effectiveness of oral semaglutide vs. sitagliptin was DKK 95,093/QALY (€12,746). The SUSTAIN 2 analysis estimated the cost-effectiveness of subcutaneous semaglutide vs. sitagliptin was DKK 79,982/QALY (€10,721). The SUSTAIN 8 analysis estimated the cost-effectiveness of subcutaneous semaglutide vs. canagliflozin was DKK 167,664/QALY (€22,474). CONCLUSIONS Daily oral and weekly subcutaneous semaglutide are likely to both increase cost and health benefits, but are likely to do so under commonly considered cost-effectiveness thresholds. TRIAL REGISTRATIONS Clinicaltrials.gov: NCT02863328 (PIONEER 2; registered August 11, 2016); NCT02607865 (PIONEER 3; registered November 18, 2015); NCT01930188 (SUSTAIN 2; registered August 28, 2013); NCT03136484 (SUSTAIN 8; registered May 2, 2017).
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Emara RA, Hamed M, Awad M, Zeid W. Effect of diabetes self-management education program on glycemic control in diabetic patients attending the family medicine outpatient clinic, Suez Canal University Hospital, Ismailia, Egypt. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.1186/s43162-021-00058-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Diabetes mellitus (DM) is a chronic disease with debilitating complications. Patients with diabetes are recommended to take various self-management decisions and carry out complex care activities. Diabetes self-management education (DSME) and support help people with diabetes to take these decisions and activities to improve health outcomes. DSME may serve as the basis to minimize and avoid catastrophic diabetes-related complications and the resulting financial and personal costs associated with this disorder. We aimed to assess the effect of diabetes self-management education program on glycemic control on patients with diabetes. A quasi-experimental pre-post study was conducted at the family medicine clinic in Suez Canal University hospital, Ismailia, Egypt. A total of 116 patients with uncontrolled DM were recruited by a simple random technique after applying the inclusion and exclusion criteria. Participants were subjected to a 12-week health education program (1 session/week). The sessions focused on areas of diabetes self-management based on the American Diabetes Association (ADA) guidelines. The glycosylated hemoglobin (HbA1c) was assessed at baseline and again at the end of the program. Also, self-care activities were evaluated pre-post intervention using the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA) instrument which measured the activities related to diet, exercise, blood sugar testing, foot care, and medications.
Results
The mean age of participants was 47 years (± 11.54), male patients represented 54%. About two-thirds (67%) were from urban areas and came from a middle socioeconomic level. About half of the participants (51.7%) were diagnosed as diabetics for 5–10 years duration. More than half (52.7%) were on combination therapy of insulin and oral antidiabetic drugs. After the intervention program, there was a statistically significant decrease in HbA1c level (p value < 0.001), and 21% of the participants reached the ADA treatment goal for HbA1c below 7.
Conclusion
Appropriate DSME programs are practical and have a benefit to patients with diabetes.
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Azmiardi A, Murti B, Febrinasari RP, Tamtomo DG. The Effect of Peer Support in Diabetes Self-Management Education on Glycemic Control in Patients with Type 2 Diabetes: A Meta-Analysis. Epidemiol Health 2021; 43:e2021090. [PMID: 34696569 PMCID: PMC8920738 DOI: 10.4178/epih.e2021090] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Diabetes self-management education (DSME) programs are a strategy to maintain healthy behaviors. Nevertheless, limited evidence has been reported from systematic evaluations of the effects of DSME integrated with peer support on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes. METHODS A systematic search was carried out in electronic databases, including PubMed, Cochrane Library, ProQuest, SpringerLink, ScienceDirect, Scopus, and Google Scholar, for English-language articles published from 2005 until 2020. The effect size was estimated as the standard mean difference (SMD). The Cochrane Collaboration’s Risk of Bias tool was employed to assess the risk of bias. RESULTS Twelve studies were included in this study. DSME integrated with peer support effectively reduced glycated hemoglobin A1c (HbA1c) levels, with a statistically significant effect (SMD, -0.41; 95% confidence interval [CI], -0.69 to -0.13; p<0.001). Programs with a sample size <100 (SMD, -0.45; 95% CI, -0.79 to -0.11; p=0.009), duration of intervention ≤6 months (SMD, -0.52; 95% CI, -0.96 to -0.07; p=0.020), baseline HbA1c <8.5% (SMD, -0.42; 95% CI, -0.77 to -0.07; p=0.020), delivery by group (SMD, -0.28; 95% CI, -0.51 to -0.06; p=0.010), and high frequency of contact (SMD, -0.29; 95% CI, -0.48 to -0.10; p=0.003) had statistically significant effects on reducing HbA1c levels in patients with type 2 diabetes. CONCLUSIONS DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Programs with smaller participants groups, shorter interventions, weekly meetings, and closer group sessions improved glycemic control in patients with type 2 diabetes.
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Affiliation(s)
- Akhmad Azmiardi
- Doctoral Program on Public Health, Universitas Sebelas Maret, Surakarta, Indonesia, Surakarta, Indonesia
| | - Bhisma Murti
- Doctor of Public Health Program, Universitas Sebelas Maret, Surakarta, Indonesia, Surakarta, Indonesia
| | - Ratih Puspita Febrinasari
- Department of Pharmacology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia, Surakarta, Indonesia
| | - Didik Gunawan Tamtomo
- Doctor of Public Health Program, Universitas Sebelas Maret, Surakarta, Indonesia, Surakarta, Indonesia
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Saboo B, Kesavadev J, Shankar A, Krishna MB, Sheth S, Patel V, Krishnan G. Time-in-range as a target in type 2 diabetes: An urgent need. Heliyon 2021; 7:e05967. [PMID: 33506132 PMCID: PMC7814148 DOI: 10.1016/j.heliyon.2021.e05967] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/16/2020] [Accepted: 01/08/2021] [Indexed: 01/17/2023] Open
Abstract
Time-in-range emerged as a valuable blood glucose metric, 'beyond HbA1c' for a deeper insight into glycemic control in people with diabetes. It denotes the proportion of time that a person's glucose level remains within the desired target range (usually 70-180 mg/dL or 3.9-10.0 mmol/L). Though clinical targets in the current recommendations for type 1 and type 2 diabetes are close enough, their clinical profiles and prevalences are quite different. Type 2 diabetes is the commonest form of diabetes. Many clinical trials have challenged the usefulness of HbA1c as a glycemic target for Type 2 diabetes mellitus. On account of the higher prevalence and complications of type 2 diabetes, more outcomes-based studies are needed to associate time-in-range with its ongoing risk. These studies strongly support the dependability of time-in-range to identify patients with elevated risk in type 2 diabetes. We discuss the utility of time-in-range, a new metric of continuous glucose monitoring as an outcome measure to correlate with type 2 diabetes risks and complications and to analyze the effectiveness of type 2 diabetes management. This approach may support the use of time-in-range as a metric for long-term health outcomes in the type 2 diabetes population.
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Affiliation(s)
| | - Jothydev Kesavadev
- Jothydev's Diabetes Research Centre, Mudavanmugal, Thiruvananthapuram, Kerala, India
| | - Arun Shankar
- Jothydev's Diabetes Research Centre, Mudavanmugal, Thiruvananthapuram, Kerala, India
| | - Meera B Krishna
- Jothydev's Diabetes Research Centre, Mudavanmugal, Thiruvananthapuram, Kerala, India
| | | | | | - Gopika Krishnan
- Jothydev's Diabetes Research Centre, Mudavanmugal, Thiruvananthapuram, Kerala, India
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