Volume 22 Issue 3
Mar.  2024
Turn off MathJax
Article Contents
WU Daoai, JIN Guoxi, SHI Zhaoming, WU Chenchen, SUN Weihua, CHEN Li. Correlation between time in range and diabetic foot in patients with type 2 diabetes mellitus[J]. Chinese Journal of General Practice, 2024, 22(3): 414-417. doi: 10.16766/j.cnki.issn.1674-4152.003415
Citation: WU Daoai, JIN Guoxi, SHI Zhaoming, WU Chenchen, SUN Weihua, CHEN Li. Correlation between time in range and diabetic foot in patients with type 2 diabetes mellitus[J]. Chinese Journal of General Practice, 2024, 22(3): 414-417. doi: 10.16766/j.cnki.issn.1674-4152.003415

Correlation between time in range and diabetic foot in patients with type 2 diabetes mellitus

doi: 10.16766/j.cnki.issn.1674-4152.003415
Funds:

 202204295107020049

 2020byzd112

  • Received Date: 2023-05-18
    Available Online: 2024-05-27
  •   Objective  To investigate the correlation between glycemic variability such as time in range (TIR) and diabetic foot (DF).  Methods  The study included 163 inpatients with T2DM who underwent prompt dynamic blood glucose monitoring at the Department of Endocrinology, the First Affiliated Hospital of Bengbu Medical University between January 2020 and December 2020. The participants were divided into two groups based on the presence or absence of DF: the DF group (n=26) and the non-DF group (NDF, n=137). The DF group were divided into two sub-groups based on the Wagner classification: Wagner grade 3 group (n=17), Wagner grade 4 group (n=9). All patients underwent fundus photography and sensory threshold (VPT) measurement, additionally, their glucose levels were monitored using TIR, time above range (TAR), time below range (TBR), glucose coefficient of variation (CV) and mean amplitude of glycemic excursions (MAGE). The above indices were compared statistically.  Results  TIR [(35.19±10.94) % vs. (44.79±10.60) %], CV [36.65 (29.45, 38.75) % vs. 29.90 (24.60, 34.80) %], TAR [(61.46±12.21) % vs.(54.01±11.22) %], TBR [1.00 (0.00, 5.75) % vs. 0.00 (0.00, 1.00) %], fundus photography (19/26 vs. 96/137) and abnormal proportion of VPT (25/26 vs. 45/137), there were statistical differences between the DF and NDF groups. The rates of CRP and VPT were higher in the Wagner grade 3 and 4 groups compared to the NDF group. Additionally, the TIR was lower in both groups compared to the NDF group, with statistically significant differences. The results of the multiple logistic regression analysis indicate that CRP (OR=1.024, P=0.011), fundus radiography (OR=0.113, P=0.013) and VPT (OR=31.803, P=0.042) were independent influencing factors for DF.  Conclusion  DF can be complicated by DM retinopathy and neuropathy, and infection is an independent risk factor. A higher CV was observed with lower TIR, indicating poor and fluctuating blood glucose levels. This may be associated with the development of DF.

     

  • loading
  • [1]
    SAEEDI P, PETERSOHN I, SALPEA P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9(th) edition[J]. Diabetes Res Clin Pract, 2019, 157: 107843. DOI: 10.1016/j.diabres.2019.107843.
    [2]
    SINGH N, ARMSTRONG D G, LIPSKY B A. Preventing foot ulcers in patients with diabetes[J]. JAMA, 2005, 293(2): 217-228. doi: 10.1001/jama.293.2.217
    [3]
    DANNE T, NIMRI R, BATTELINO T, et al. International consensus on use of continuous glucose monitoring[J]. Diabetes Care, 2017, 40(12): 1631-1640. doi: 10.2337/dc17-1600
    [4]
    MONNIER L, COLETTE C, BOEGNER C, et al. Continuous glucose monitoring in patients with type 2 diabetes: why? when? whom?[J]. Diabet Metab, 2007, 33(4): 247-252. doi: 10.1016/j.diabet.2006.11.007
    [5]
    AKIROV A, SHOCHAT T, DOTAN I, et al. Glycemic variability and mortality in patients hospitalized in general surgery wards[J]. Surgery, 2019, 166(2): 184-192. doi: 10.1016/j.surg.2019.02.022
    [6]
    陈莹, 郗光霞, 马羽琦, 等. 血糖漂移对糖尿病患者心肌损伤的机制研究[J]. 中国现代医学杂志, 2019, 29(12): 53-57. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXDY201912012.htm
    [7]
    周建华, 李晓华, 贝鹏剑, 等. 早期2型糖尿病肾病患者血糖波动与氧化应激、炎症及单核细胞自噬的相关性[J]. 中国老年学杂志, 2021, 1(41): 32-36. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202101009.htm
    [8]
    ZHANG C, TANG M, LU X, et al. Relationship of ankle-brachial index, vibration perception threshold, and current perception threshold to glycemic variability in type 2 diabetes[J]. Medicine, 2020, 99(12): e19374. DOI: 10.1097/MD.0000000000019374.
    [9]
    KERR M, BARRON E, CHADWICK P, et al. The cost of diabetic foot ulcers and amputations to the National Health Service in England[J]. Diabet Med, 2019, 36(8): 995-1002. doi: 10.1111/dme.13973
    [10]
    WALSH J W, HOFFSTAD O J, SULLIVAN M O, et al. Association of diabetic foot ulcer and death in a population-based cohort from the United Kingdom[J]. Diabet Med, 2016, 33(11): 1493-1498. doi: 10.1111/dme.13054
    [11]
    段皓, 刘国亭, 孙宏武, 等. 红细胞沉降率、C反应蛋白、糖尿病周围神经病变与糖尿病足溃疡严重程度的相关性研究[J]. 足踝外科电子杂志, 2021, 8(1): 22-26. https://www.cnki.com.cn/Article/CJFDTOTAL-WKZH202101005.htm
    [12]
    李颖, 黄奕娟, 梁晓康, 等. 基于眼底照片影像组学特征的糖尿病足分类模型构建[J]. 中华内分泌代谢杂志, 2023, 39(2): 103-111.
    [13]
    VALENTE T, ARBEX A K. Glycemic variability, oxidative stress, and impact on complications related to type 2 diabetes mellitus[J]. Curr Diabetes Rev, 2021, 17(7): 1-11.
    [14]
    高霜, 张艳丽, 吴姗姗, 等. 2型糖尿病患者的糖尿病痛苦现状调查及影响因素分析[J]. 中华全科医学, 2020, 18(12): 2136-2139. doi: 10.16766/j.cnki.issn.1674-4152.001707
    [15]
    BATTELINO T, DANNE T, BERGENSTAL R M, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range[J]. Diabetes Care, 2019, 42(8): 1593-1603.
    [16]
    王珍珍, 曹永红, 戴武. 葡萄糖在目标范围内时间与2型糖尿病患者心脏自主神经病变的相关性研究[J]. 安徽医学, 2022, 43(4): 386-390. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYX202204004.htm
    [17]
    方旭光, 邵小娟, 马卫国, 等. 葡萄糖在目标范围内时间与糖尿病足的相关性研究[J]. 中华糖尿病杂志, 2022, 14(7): 650-655. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202403014.htm
    [18]
    郗光霞, 安平, 梁登耀, 等. 糖化血红蛋白水平和血糖波动与氧化应激关系的研究[J]. 中国糖尿病杂志, 2021, 29(2): 99-103. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTL202102005.htm
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Article Metrics

    Article views (142) PDF downloads(8) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return