Introduction & Objective: Paradoxical increase of postprandial glucagon is considered to be a factor inducing hyperglycemia in type 2 diabetes (T2D). Although continuous glucose monitoring (CGM) is often used to evaluate glycemic control in T2D patients, no studies on the association between glycemic stability and functional balance of pancreatic alpha to beta cells have been reported. We aimed to investigate the association between CGM data and the ratio of glucagon to insulin secretion.

Methods: We recruited 62 T2D patients who were admitted to our hospital, and patients with <45 ml/min/1.73 m2 of eGFR were excluded. We analyzed the data obtained from CGM, including time in range (TIR), time below range (TBR), time above range (TAR), average glucose (AVG), and standard deviation of glucose (SD), and the ratio of plasma glucagon level to C-peptide index (G-CPIR) before and after meal tolerance test or other metabolic factors.

Results: Postprandial G-CPIR was inversely correlated with TIR (r = -0.230, P = 0.009), correlated with TAR (r = 0.234, P = 0.014), and AVG (r = 0.251, P = 0.006). Upon comparing the CGM data between the group with high postprandial G-CPIR (HG group) and low G-CPIR (LG group), divided using the median values, TIR was significantly lower (62.4±21.5 vs. 78.5±18.8, P = 0.0053), AVG (166.7±33.5 vs. 145.5±27.9, P = 0.0153) and SD (46.2±14.3 vs. 38.2±11.8, P = 0.0310) were higher than those in LG group. Body fat mass was inversely correlated with SD (r = -0.448, P = 0.014), and subcutaneous fat area (SFA) and visceral fat area (VFA) were correlated with TIR (SFA: r = 0.339, P = 0.006, VFA: r = 0.310, P = 0.032), inversely correlated with TAR (SFA: r = -0.326, P = 0.010, VFA: r = -0.298, P = 0.040) and SD (SFA: r = -0.411, P = 0.001, VFA: r = -0.454, P = 0.001).

Conclusion: Our study suggests that CGM indicators, including TIR, are associated with the functional balance of pancreatic alpha to beta cells and body fat mass.

Disclosure

M. Kamigishi: None. D. Chujo: Research Support; Kyowa Kirin Co., Ltd. A. Takikawa: None. S. Inagawa: None. A. Enkaku: None. S. Ohgaku: None. A. Sato: None. S. Matsukoshi: None. H. Honoki: None. S. Fujisaka: None. K. Tobe: None.

© 2024 by the American Diabetes Association
2024
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