Correlation Between Continuous Glucose Monitoring Derived Time In Range And Sudomotor Function In Type 2 Diabetes Mellitus And Type 1 Diabetes Mellitus

Chapter one:Correlation between Continuous Glucose Monitoring derived Time in Range and sudomotor function in type 2 diabetes mellitusBackground:Time in range(TIR)is advocated as a key metric of glycemic control.Sudomotor dysfunction is among the earliest detectable diabetic peripheral neuropathy(DPN).We set about to research the relationship between TIR including overnight TIR and sudomotor function detected by SUDOSCAN with the intention of exploring the correlation of TIR including overnight TIR and early DPN in type 2 diabetes(T2DM).Methods:We included 1026 individuals with T2DM who both wore three-day CGM(Meiqi Corporation)and underwent sudomotor function test during their-hospitalization at the incretion department from October 2017 to July 2020.The clinical biochemical indicators were recorded also.Sudomotor function was evaluated by SUDOSCAN on the basis of ESC(use μS said)measured on the feet.Using 60μS as the cut-off point,participants were divided into normal and abnormal sudomotor function group(n=776,250,respectively).CGM metrics were compared between groups.The relationship between TIR and nocturnal TIR and sudomotor function was analyzed through regression analysis.Results:By comparison,patients with sudomotor dysfunction had lower TIR and nocturnal TIR(all P<0.001).The sudomotor dysfunction prevalence progressively declined with the ascending quartiles of TIR(P for trend<0.001).Linear regression analysis illuminated the positive correlation between TIR and nighttime TIR and FESC.Finally,multivariate logistic regression analysis depicted that TIR and nighttime TIR were independently linked with sweat gland function(P<0.001).Notably the correlation between nocturnal TIR and sudomotor dysfunction was more statistically significant.Conclusion:TIR and nocturnal TIR are linked with sudomotor function in patients with T2DM.Furthermore,decreased nocturnal TIR is more closely related to the impaired function of sudomotor nerves in sweat glands.Chapter two:Correlation between Continuous Glucose Monitoring derived Time in Range and sudomotor function in type 1 diabetes mellitusAim:To research the association between time in range(TIR)including overnight TIR and sudomotor function detected by SUDOSCAN in patients with type 1 diabetes mellitus(T1DM).Methods:95 patients with T1DM were enrolled.TIR including nocturnal TIR of 3.9-10.0 mmol/L was evaluated with CGM.SUDOSCAN measured feet electrochemical skin conductance(FESC)and sudomotor dysfunction was defined as average FESC<60μS.Logistic regressions were then applied to examine the independent association of TIR and overnight TIR with sudomotor function.Results:The overall prevalence of sudomotor dysfunction was 28.42%.Patients with sudomotor dysfunction had significantly lower TIR for the whole recorded phase and for nighttime.The sudomotor dysfunction prevalence progressively declined with the ascending tertiles of TIR and nocturnal TIR(P for trend<0.05).Finally,logistic regression analysis indicated the independently negative relation between TIR and nocturnal TIR and sudomotor dysfunction(P<0.05)after adjusting compounding variables including sex,age,diabetes duration,BMI,Alb,smoking,BUN,DKD,and HbAlc.Notably the correlation between nocturnal TIR and sudomotor function was more statistically significant.Conclusions:TIR and nocturnal TIR are negatively correlated with sudomotor dysfunction in T1DM independent of HbAlc.Furthermore,decreased nocturnal TIR is more closely related to the impaired function of sudomotor nerves in sweat glands.