Correlation Between Metrics Of Continuous Glucose Monitoring And Low Extremity Arterial Disease In Patients With Type 2 Diabetes

Objective:To verify the correlation TIR,TAR,TBR levels and LEAD in patients with type 2 diabetes,which can provide clinical evidence for the prevention and treatment of LEAD.Methods:A total of 45 patients with type 2 diabetes were recruited from the Department of Endocrinology at the First People’s Hospital of Chenzhou from April 2021 to February 2022.According to diagnostic criteria of LEAD,they were be divided into two groups:group A(including 21 cases with LEAD)and group B(including 24 cases without LEAD).Clinical information and laboratory characteristics were collected.All patient used continuous glucose monitoring for 72 consecutive hours with The Pro Doctor continuous glucose monitoring system.After the 72-hour monitoring period,TIR,TAR and TBR were calculated and summarized.SPSS 26.0 software was used for statistics analysis.Without special instructions,P<0.05 was considered as statistically significant.Results:1.The age,duration,systolic blood pressure,HbAlc,total cholesterol and treatment between the two groups were statistically significant(P<0.05).But the gender,diastolic blood pressure,BMI,triglyceride,high density lipoprotein and low density lipoprotein between the two groups were no statistically significant difference(P>0.05);2.The TIR level in group A[22.54±16.86 vs 68.85±15.02,P<0.001]was lower than that in group B,and the TAR level in group A[72.95±22.08 vs 26.23±15.74,P<0.001]was higher than that in group B.While there was no statistically significant difference between groups regarding TBR(P>0.05);3.TIR was negatively correlated with HbAlc(r=-0.469,P=0.001).TAR was positively correlated with HbAlc(r=0.432,P=0.003).However,TBR was not correlated with HbAlc(P>0.05);4.When the TIR level was<37.5%,37.5-57%,57-74%and≥74%,the incidence of LEAD was 100%,54.55%,27.27%and 8.33%respectively.The overall comparison of LEAD incidence was statistically significant(P=0.001).Compared with Q1,the incidence of LEAD in Q3 and Q4 were statistically significant(P<0.001);5.When the TAR level was<18.5%,18.5-34%,34-60.34%and≥60.34%,the incidence of LEAD was 18.18%,18.18%,54.55%and 90.91%respectively.The overall comparison of LEAD incidence was statistically significant(P=0.001).Compared with A4,the incidence of LEAD in A1 and A2 were statistically significant(P=0.001):6.When the TBR level was<2%,2-8%,≥8%,the incidence of LEAD was 42.86%,53.85%and 45.45%respectively.The differences were not statistically significant in the overall comparison(P>0.05)and intra-groups about the incidence of LEAD;7.Logistic regression analysis showed that TIR was a protective factor to LEAD[OR=0.878,95%CI(0.814,0.946),P=0.001].After adjusting for confounding factors,TIR was an independent protective factor to LEAD[OR=0.842,95%CI(0.715,0.992),P=0.040];8.Logistic regression analysis showed that TAR was a risk factor to LEAD[OR=1.087,95%CI(1.044,1.133),P<0.001].After adjusting for confounding factors,TAR is an independent risk factor to LEAD[OR=1.062,95%CI(1.003,1.124),P=0.039];9.The area under curve of TIR was 0.966[95%CI(0.922,1.000),P<0.001].When the cut-off value was 62.5%,the sensitivity and specificity of predicting LEAD was 85.7%and 95.8%respectively.The area under curve of TAR was 0.933[95%CI(0.854,1.000),P<0.001].When the cut-off value was 65.3%,the sensitivity and specificity of predicting LEAD was 85.7%and 95.8%respectively.Conclusions:1.TIR is an independent protective factor to LEAD,while TAR is an independent risk factor to LEAD in patients with type 2 diabetes;2.TIR and TAR are clinical measures for diagnosis of LEAD in patients with type 2 diabetes.