Objective: To investigate the prevalence, characteristic and chronic complications of patients with the fast-glycator phenotype in type 1 diabetes (T1D), as well as the relationship between the fast-glycator phenotype and hemoglobin glycation index (HGI).
Methods: We enrolled individuals with T1D who utilized the continuous glucose monitoring system (CGM) for at least 10 days. Skin advanced glycation end products (AGEs) was measured by a spectroscopy device. Chronic complications were assessed through a standardized screening process. Glucose management indicator to HbA1c ratio < 0.9 was defined as a fast-glycator phenotype.
Results: We included 418 participants of T1D (59.3% female) with a median age of 17 years and a median duration of 28 months. 109 individuals (26.1%) were classified as having the fast-glycator phenotype. The prevalence of the fast-glycator phenotype was higher in patients who were adult-onset (38.6% vs. 14.9%, P<0.001), female (31.5% vs. 18.2%, P=0.003) and having a duration of 10 years or more (48.0% vs. 19.2%, P<0.001) than their counterparts. Fast-glycators had significantly higher HbA1c (8.3% vs. 6.9%, P < 0.001) with similar GMI (6.8% vs. 6.8%, P=0.663) compared with non-fast-glycators. Fast-glycators had notably higher skin AGEs (75.5 vs. 65.2, P < 0.001) and HGI (1.16% vs. 0.17%, P < 0.001), as well as increased prevalence of retinopathy (43.1% vs. 19.7%, P < 0.001), regardless of adjusting for age, duration of diabetes.
Conclusions: Fast-glycator phenotype is more prevalent in adults, females, and patients with longer disease duration in T1D, associated with higher risk of retinopathy, and increased skin AGEs and HGI.
C. Deng: None. R. Xu: None. W. Fan: None. X. Li: None.
