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Lima RAD, Fernandes DR, Garcia RAC, Carvalho LADR, Silveira RCDCP, Teixeira CRDS. Correlation between time on target and glycated hemoglobin in people with diabetes mellitus: systematic review. Rev Lat Am Enfermagem 2023; 31:e4088. [PMID: 38055596 PMCID: PMC10695292 DOI: 10.1590/1518-8345.6655.4088] [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: 01/06/2023] [Accepted: 09/19/2023] [Indexed: 12/08/2023] Open
Abstract
to analyze the correlation between time on target and glycated hemoglobin in people living with diabetes mellitus and carrying out continuous blood glucose monitoring or self-monitoring of capillary blood glucose. systematic review of etiology and risk based on JBI guidelines and reported according to Preferred Reporting Items for Systematic Reviews and Meta- Analyses, covering six databases and grey literature. The sample included 16 studies and methodological quality was assessed using JBI tools. Protocol registered in the Open Science Framework, available at https://doi.org/10.17605/OSF.IO/NKMZB. time on target (70-180 mg/dl) showed a negative correlation with glycated hemoglobin, while time above target (>180 mg/dl) showed a positive correlation. Correlation coefficients ranged between -0.310 and -0.869 for time on target, and between 0.66 and 0.934 for time above target. A study was carried out on a population that performed self-monitoring. there is a statistically significant correlation between time on target and time above target with glycated hemoglobin. The higher the proportion in the adequate glycemic range, the closer to or less than 7% the glycated hemoglobin will be. More studies are needed to evaluate this metric with data from self-monitoring of blood glucose.
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Affiliation(s)
- Rafael Aparecido Dias Lima
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Daiane Rubinato Fernandes
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
- Becaria de la Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Rute Aparecida Casas Garcia
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | | | - Renata Cristina de Campos Pereira Silveira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Carla Regina de Souza Teixeira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
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Shen Y, Yang Q, Hu T, Wang Y, Chen L, Gao F, Zhu W, Hu G, Zhou J, Wang C, Bao Y. Association of prolactin with all-cause and cardiovascular mortality among patients with type 2 diabetes: a real-world study. Eur J Prev Cardiol 2023; 30:1439-1447. [PMID: 37042353 DOI: 10.1093/eurjpc/zwad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/31/2023] [Accepted: 04/07/2023] [Indexed: 04/13/2023]
Abstract
AIMS The association between prolactin and mortality has been less studied, and findings were inconsistent among different populations. We aimed to investigate the association between serum prolactin (PRL) and mortality among patients with type 2 diabetes. METHODS AND RESULTS We performed a retrospective cohort study of 10 907 patients with at least 2 prolactin measurements within 2 years since their first inpatient diagnosis of type 2 diabetes. Baseline and mean values of serum PRL were used as exposures. A multivariable-adjusted Cox proportional hazards model was used to estimate the association between PRL and mortality. During a mean follow-up of 5.34 years, 863 patients died, of whom 274 were due to cardiovascular events. Multivariable-adjusted hazard ratios (aHRs) based on different levels of baseline PRL (<100, 100-199, 200-299, and ≥300 mIU/L) were 1.00, 1.10 [95% confidence interval (CI), 0.90-1.36], 1.35 (95% CI 1.11-1.67), and 1.49 (95% CI 1.18-1.84) for all-cause mortality and 1.00, 1.24 (95% CI 0.86-1.81), 1.71 (95% CI 1.14-2.62), and 2.42 (95% CI 1.55-3.78) for cardiovascular mortality, respectively. Positive associations were also found when we used the mean values of PRL as the exposure. These associations were consistent among patients of different baseline characteristics. Further sensitivity analyses excluding patients with subclinical or clinical hypothyroidism at baseline and who died within the first 6 months since baseline demonstrated similar results. CONCLUSIONS A positive association between baseline PRL and mortality was observed among patients with type 2 diabetes. Prolactin may be considered a potential biomarker of mortality among patients with type 2 diabetes.
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Affiliation(s)
- Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China
| | - Qing Yang
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China
| | - Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China
| | - Yaxin Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China
| | - Lei Chen
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China
| | - Fei Gao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China
| | - Wei Zhu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China
| | - Gang Hu
- Chronic Disease Epidemiology, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China
| | - Chunfang Wang
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China
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Gao X, Li H, Yu Y, Huai X, Feng B, Song J. Relationship Between Time in Range and Dusk Phenomenon in Outpatients with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2023; 16:1637-1646. [PMID: 37304668 PMCID: PMC10257429 DOI: 10.2147/dmso.s410761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023] Open
Abstract
Purpose The dusk phenomenon refers to a spontaneous and transient pre-dinner hyperglycemia that affects glucose fluctuation and glycemic control, and the increasing use of continuous glucose monitoring (CGM) has facilitated its diagnosis. We investigated the frequency of the dusk phenomenon and its relationship with the time in range (TIR) in patients with type 2 diabetes mellitus (T2DM). Patients and Methods This study involved 102 patients with T2DM who underwent CGM for 14 days. CGM-derived metrics and clinical characteristics were evaluated. A consecutive dusk blood glucose difference (pre-dinner glucose minus 2-hour post-lunch glucose) of ≥ 0 or once-only dusk blood glucose difference of < 0 was diagnosed as the clinical dusk phenomenon (CLDP). Results We found that the percentage of CLDP was 11.76% (10.34% in men, 13.64% in women). Compared with the non-CLDP group, the CLDP group tended to be younger and have a lower percentage of TIR (%TIR3.9-10) and higher percentage of time above range (%TAR>10 and %TAR>13.9) (P ≤ 0.05). Adjusted for confounding factors, the binary logistic regression analysis showed a negative association of CLDP with %TIR (odds ratio < 1, P < 0.05). We repeated the correlation analysis based on 70%TIR and found significant differences in hemoglobin A1c, fasting blood glucose, mean blood glucose, standard deviation of the sensor glucose values, glucose coefficient of variation, largest amplitude of glycemic excursions, mean amplitude of glycemic excursions, glucose management indicator, and percentage of CLDP between the two subgroups of TIR ≤ 70% and TIR > 70% (P < 0.05). The negative association between TIR and CLDP still remained after adjustment by the binary logistic regression analysis. Conclusion The CLDP was frequently present in patients with T2DM. The TIR was significantly correlated with the CLDP and could serve as an independent negative predictor.
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Affiliation(s)
- Xiangyu Gao
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
| | - Hongmei Li
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
| | - Yuan Yu
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
| | - Xiaoyuan Huai
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
| | - Bo Feng
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
| | - Jun Song
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
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Bergenstal RM, Hachmann-Nielsen E, Kvist K, Peters AL, Tarp JM, Buse JB. Increased Derived Time in Range Is Associated with Reduced Risk of Major Adverse Cardiovascular Events, Severe Hypoglycemia, and Microvascular Events in Type 2 Diabetes: A Post Hoc Analysis of DEVOTE. Diabetes Technol Ther 2023; 25:378-383. [PMID: 37017470 PMCID: PMC10398723 DOI: 10.1089/dia.2022.0447] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Time spent in glycemic target range (time in range [TIR]; plasma glucose 70-180 mg/dL [3.9-10.0 mmol/L]) as a surrogate endpoint for long-term diabetes-related outcomes requires validation. This post hoc analysis investigated the association between TIR, derived from 8-point glucose profiles (derived TIR [dTIR]) at 12 months, and time to cardiovascular or severe hypoglycemic episodes in people with type 2 diabetes in the DEVOTE trial. At 12 months, dTIR was significantly negatively associated with time to first major adverse cardiovascular event (P = 0.0087), severe hypoglycemic episode (P < 0.0001), or microvascular event (P = 0.024). A nonsignificant trend was seen toward association between 12-month hemoglobin A1c (HbA1c) and these outcomes, but this was no longer seen after addition of dTIR to the model. The results support targeting TIR >70% and suggest dTIR could be used in addition to, or in some instances in place of, HbA1c as a clinical biomarker. Trial registration details: ClinicalTrials.gov, NCT01959529.
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Affiliation(s)
- Richard M. Bergenstal
- International Diabetes Center, HealthPartners Institute, 3800 Park Nicollet Blvd, Minneapolis, Minnesota, USA
| | | | - Kajsa Kvist
- Data Science, Novo Nordisk A/S, Søborg, Denmark
| | - Anne L. Peters
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | | | - John B. Buse
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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