PMID- 29516622
OWN - NLM
STAT- MEDLINE
DCOM- 20181127
LR  - 20181127
IS  - 1520-7560 (Electronic)
IS  - 1520-7552 (Linking)
VI  - 34
IP  - 5
DP  - 2018 Jul
TI  - New insights from continuous glucose monitoring into the route to diabetes.
PG  - e3002
LID - 10.1002/dmrr.3002 [doi]
AB  - AIM: Type 2 diabetes mellitus (T2DM) is preceded by a period of impaired 
      glucoregulation. We investigated if continuous glucose monitoring system (CGMS) 
      (1) could improve our capacity to predict the development of T2DM in subjects at 
      risk. (2) Find out if impaired fasting glucose/impaired glucose tolerance 
      differentiation through CGMS would also elucidate differences in clinical 
      phenotypes. MATERIAL AND METHODS: Observational study of 209 hypertensive 
      patients, aged 18 to 85 years who wore at entry a CGMS. Two CGMS metrics, percent 
      of time under the 100 mg/dL glycaemic threshold (TU100) (impaired fasting glucose 
      surrogate phenotype) and area above the 140 mg/dL glycemic threshold (AO140) 
      (impaired glucose tolerance surrogate phenotype) were measured. The median 
      follow-up was 32 months (6-72 mo), and there were 17 new cases of T2DM. RESULTS: 
      In a multivariate Cox proportional hazard survival analysis including the 
      conventional prediabetes-defining criteria and the 2 CGMS-derived variables, only 
      TU100 and HbA(1c) were significant and independent variables in predicting T2DM 
      development. An increase in 0.1 in TU100 resulted in a 0.69 (95% CI, 0.54-0.88; 
      P < .01) odds ratio of developing T2DM. With cut-off points of 0.5 for TU100 and 
      5.7% for HbA(1c) , the test "TU < 0.5 and HbA(1c)  > 5.7%" had a sensitivity of 
      0.81 (SD, 0.10), a specificity of 0.83 (SD, 0.03), and a likelihood ratio of 4.82 
      (SD, 1.03) for T2DM development. CONCLUSIONS: Continuous glucose monitoring 
      system allows for a better T2DM risk-development categorization than fasting 
      glucose and HbA(1c) in a high-risk population. Continuous glucose monitoring 
      system-derived phenotyping reveals clinical differences, not disclosed by 
      conventional fasting plasma glucose/HbA(1c) categorization. These differences may 
      correlate with distinct pathophysiological mechanisms.
CI  - Copyright (c) 2018 John Wiley & Sons, Ltd.
FAU - Colas, Ana
AU  - Colas A
AD  - Internal Medicine, Hospital Universitario de Mostoles, Mostoles, Madrid, Spain.
FAU - Vigil, Luis
AU  - Vigil L
AUID- ORCID: 0000-0001-7484-2911
AD  - Internal Medicine, Hospital Universitario de Mostoles, Mostoles, Madrid, Spain.
FAU - Rodriguez de Castro, Carmen
AU  - Rodriguez de Castro C
AD  - Internal Medicine, Hospital Universitario de Mostoles, Mostoles, Madrid, Spain.
FAU - Vargas, Borja
AU  - Vargas B
AD  - Internal Medicine, Hospital Universitario de Mostoles, Mostoles, Madrid, Spain.
FAU - Varela, Manuel
AU  - Varela M
AD  - Internal Medicine, Hospital Universitario de Mostoles, Mostoles, Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20180410
PL  - England
TA  - Diabetes Metab Res Rev
JT  - Diabetes/metabolism research and reviews
JID - 100883450
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/*blood
MH  - Blood Glucose/*analysis
MH  - Blood Glucose Self-Monitoring/*methods
MH  - Diabetes Mellitus, Type 2/blood/*diagnosis/etiology
MH  - Female
MH  - Follow-Up Studies
MH  - Glucose Intolerance/blood/*diagnosis/etiology
MH  - Humans
MH  - Hypertension/*complications
MH  - Male
MH  - Middle Aged
MH  - Prediabetic State/blood/*diagnosis/etiology
MH  - Prognosis
MH  - Survival Rate
MH  - Young Adult
OTO - NOTNLM
OT  - continuous glucose monitoring system
OT  - diabetes risk development
OT  - impaired fasting glucose
OT  - impaired glucose tolerance
EDAT- 2018/03/09 06:00
MHDA- 2018/11/28 06:00
CRDT- 2018/03/09 06:00
PHST- 2018/01/10 00:00 [received]
PHST- 2018/02/19 00:00 [revised]
PHST- 2018/02/20 00:00 [accepted]
PHST- 2018/03/09 06:00 [pubmed]
PHST- 2018/11/28 06:00 [medline]
PHST- 2018/03/09 06:00 [entrez]
AID - 10.1002/dmrr.3002 [doi]
PST - ppublish
SO  - Diabetes Metab Res Rev. 2018 Jul;34(5):e3002. doi: 10.1002/dmrr.3002. Epub 2018 
      Apr 10.