Time in Range Analysis and Glucose Variability in Type 1 Diabetic Patients with Different Stages of Chronic Kidney Disease

摘要

The aim: to assess the relationships between glucose variability (GV) parameters and renal function in patients with type 1 diabetes (T1D) at different stages of chronic kidney disease (CKD). Materials and Methods: We observed 127 patients with T1D, 48 M/79 F, from 18 to 72 years of age. Patients were divided into 5 groups: 1) no signs of CKD (CKD0), n=27; 2) CKD C1-C2, n=67; 3) CKD C3-C4, n=26; 5) CKD C5 (hemodialysis, n=7). Time in ranges and GV parameters: Mean Amplitude of Glucose Excursions (MAGE), Lability Index (LI), Low Blood Glucose Index (LBGI), High Blood Glucose Index (HBGI), 2-hour Continuous Overlapping Net Glycemic Action (CONGA), and Mean Absolute Glucose (MAG) were derived from 72-hour continuous glucose monitoring. Results: As compared to patients without CKD, the values of MAGE, LI, HBGI were increased significantly in patients with CKD C1-C2 (all p60 ml/min/1.73m2 HbA1c levels correlated positively with mean monitored glucose, time in hyperglycemic range, HBGI, CONGA, MAGE, LI, and MAG. On the contrary, in patients with lower eGFR none of GV parameters correlated with HbA1c. Conclusions: The results demonstrate non-linear relationships between eGFR and GV parameters in patients with T1D.