Evaluation of glycemic variability in chronic liver disease patients with type 2 diabetes mellitus using continuous glucose monitoring

被引:31
|
作者
Honda, Fumi [1 ]
Hiramatsu, Akira [1 ]
Hyogo, Hideyuki [2 ]
Aikata, Hiroshi [1 ]
Daijo, Kana [1 ]
Teraoka, Yuji [1 ]
Inagaki, Yuki [1 ]
Morio, Kei [1 ]
Kobayashi, Tomoki [1 ]
Nakahara, Takashi [1 ]
Nagaoki, Yuko [1 ]
Kawaoka, Tomokazu [1 ]
Yoneda, Masayasu [3 ]
Tsuge, Masataka [1 ]
Imamura, Michio [1 ]
Kawakami, Yoshiiku [1 ]
Ochi, Hidenori [1 ]
Chayama, Kazuaki [1 ]
机构
[1] Hiroshima Univ, Inst Biomed & Hlth Sci, Dept Gastroenterol & Metab, Appl Life Sci, Hiroshima, Japan
[2] JA Hiroshima Gen Hosp, Dept Gastroenterol & Hepatol, Hiroshima, Japan
[3] Hiroshima Univ, Grad Sch Biomed Sci, Dept Mol & Internal Med, Hiroshima, Japan
来源
PLOS ONE | 2018年 / 13卷 / 04期
关键词
HEPATIC CIRRHOSIS; HEMOGLOBIN; INSULIN; HYPERINSULINISM; DEGRADATION; RISK;
D O I
10.1371/journal.pone.0195028
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background and aims The feature of blood glucose dynamics in patients with chronic liver disease (CLD) is marked blood glucose fluctuations. However, the detail of blood glucose dynamics is not well known. The aim of the present study was to evaluate glycemic fluctuations by continuous glucose monitoring (CGM). Materials and methods A total of 105 CLD patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. Various parameters of glycemic variability were evaluated. The association of these parameters with liver functional reserve was examined. The parameters were also evaluated according to glycated hemoglobin A1c (HbA1c) levels. Results and discussion Data of all patients showed that mean blood glucose (MBG) levels and the difference between highest and lowest blood glucose (Delta BG) increased significantly with worsening of liver functional reserve (P < 0.001 and P = 0.005, respectively). Although many of the cases were being treated for diabetes, postprandial hyperglycemia was seen in 92% of patients. Nocturnal hypoglycemia was seen in 22% of patients. In non-anemic patients with HbA1c levels of < 7.0%, the percentage of patients with mean amplitude of glycemic excursion (MAGE) of >= 77.4 mg/dL and that of MBG levels of > 145 mg/dL were higher in liver cirrhosis (LC) patients than in chronic hepatitis (CH) patients. In them, homeostasis model assessment for insulin resistance (HOMA-IR) of > 2.5 and LC were significantly associated with the increase in MAGE. LC was also significantly associated with increased MBG levels. Conclusion The CGM systems were useful in finding hidden abnormalities of blood glucose fluctuations in CLD patients with T2DM, especially in non-anemic CLD patients with HbA1c levels of <7.0%.
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页数:13
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