PMID- 35057503
OWN - NLM
STAT- MEDLINE
DCOM- 20220202
LR  - 20220202
IS  - 2072-6643 (Electronic)
IS  - 2072-6643 (Linking)
VI  - 14
IP  - 2
DP  - 2022 Jan 13
TI  - Greater Glycemic Burden Is Associated with Further Poorer Glycemic Control in 
      Newly-Diagnosed Type 2 Diabetes Mellitus Patients.
LID - 10.3390/nu14020320 [doi]
LID - 320
AB  - Aims: hyperglycemia impairs pancreatic beta-cell function instantly, also known as 
      glucotoxicity. It is unknown whether this insult is temporary or sustained, and 
      little real-world evidence needs to reflect the relationship between 
      hyperglycemic burden, per se, and glycemic durability. Materials and Methods: a 
      retrospective observational cohort study was conducted to recruit newly-diagnosed 
      type 2 diabetes mellitus (T2DM) patients. Durability was defined as the episode 
      from first glycated hemoglobin A1c (HbA1c) below 7.0% to where it exceed 8.0% 
      (with treatment failure) or where study ended (without treatment failure). 
      Glycemic burden was defined with the area above a burden value line (HbA1c = 
      6.5%) but under the HbA1c curve (AUC), and it was then divided into two 
      compartments with the demarcation timepoint once HbA1c was treated below or equal 
      to 7.0%; the former AUC' represented the initial insult; the latter AUC" 
      represented the residual part. Multivariable regression models assessed factors 
      associated with durability in whole participants and two distinct subgroups: 
      patients with baseline HbA1c > 7.0% or </=7.0%. Results: 1048 eligible participants 
      were recruited and analyzed: 291 patients with treatment failure (durability 26.8 
      +/- 21.1 months); 757 patients without treatment failure (durability 45.1 +/- 31.8 
      months). Besides age, glycemic burden was the only constant determinant in the 
      two subgroups. AUC' or AUC" increased treatment failure, respectively, in 
      baseline HbA1c > 7.0% or </=7.0% subgroup [per 1%/90 days hazard ratio (95% 
      confidence interval): 1.026 (1.018-1.034) and 1.128 (1.016-1.253)]. Other 
      determinants include baseline HbA1c, initial OAD, and education level. 
      Conclusions: in patients with newly-diagnosed T2DM, glycemic durability was 
      negatively associated with greater glycemic burden.
FAU - Wen, Wei-Lun
AU  - Wen WL
AD  - Department of Internal Medicine, Lee's Endocrinology Clinic, Pingtung City 900, 
      Taiwan.
AD  - Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 
      Medical University, Kaohsiung 812, Taiwan.
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, 
      Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
FAU - Huang, Hui-Chun
AU  - Huang HC
AD  - Department of Electronics Engineering, Institute of Electronics, National Chiao 
      Tung University, Hsinchu 300, Taiwan.
AD  - Hengchun Navaids Site, Kaohsiung Aviation Facilities Sector, Air Navigation and 
      Weather Services, Ministry of Transportation and Communications, Hengchun 946, 
      Taiwan.
FAU - Lin, Hsiu-Chu
AU  - Lin HC
AD  - Certified Diabetic Educator of Endocrinology & Metabolism Ward, Kaohsiung Medical 
      University Hospital, Kaohsiung 807, Taiwan.
FAU - Lo, Wan-Ching
AU  - Lo WC
AD  - Department of Nursing, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, 
      Taiwan.
FAU - Chen, Szu-Chia
AU  - Chen SC
AUID- ORCID: 0000-0002-1610-4184
AD  - Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 
      Medical University, Kaohsiung 812, Taiwan.
AD  - Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
AD  - Research Center for Environmental Medicine, Kaohsiung Medical University, 
      Kaohsiung 807, Taiwan.
AD  - Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 
      807, Taiwan.
FAU - Lee, Mei-Yueh
AU  - Lee MY
AUID- ORCID: 0000-0001-8950-064X
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, 
      Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
AD  - Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 
      807, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220113
PL  - Switzerland
TA  - Nutrients
JT  - Nutrients
JID - 101521595
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Blood Glucose/drug effects
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Female
MH  - Glycemic Control/*methods
MH  - Humans
MH  - Hyperglycemia/*complications/*drug therapy
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC8780525
OTO - NOTNLM
OT  - glucotoxicity
OT  - glycemic burden
OT  - glycemic control
OT  - glycemic durability
COIS- We have no financial interest in the information contained in the manuscript.
EDAT- 2022/01/22 06:00
MHDA- 2022/02/03 06:00
PMCR- 2022/01/13
CRDT- 2022/01/21 01:17
PHST- 2021/12/12 00:00 [received]
PHST- 2022/01/09 00:00 [revised]
PHST- 2022/01/11 00:00 [accepted]
PHST- 2022/01/21 01:17 [entrez]
PHST- 2022/01/22 06:00 [pubmed]
PHST- 2022/02/03 06:00 [medline]
PHST- 2022/01/13 00:00 [pmc-release]
AID - nu14020320 [pii]
AID - nutrients-14-00320 [pii]
AID - 10.3390/nu14020320 [doi]
PST - epublish
SO  - Nutrients. 2022 Jan 13;14(2):320. doi: 10.3390/nu14020320.