Correlation Between TIR And Microvascular Disease In Early Onset Type 2 Diabetes

Purpose:According to the relevant survey of global epidemic pathology,the incidence rate of early onset type 2 diabetes(T2DM)has significantly increased.The metabolic imbalance in early onset T2DM patients occurs earlier and the risk of microvascular disease(MC)is also high,which has a negative impact on the life and physical and mental health of patients.Instant scanning blood glucose monitoring(FGM)has certain advantages in evaluating blood glucose fluctuations,with time within target range(TIR)being one of the main indicators.However,there is little research on the relationship between TIR and complications in early-onset T2DM patients.This study mainly explores the correlation between TIR and early-onset T2DM with MC,as well as the influencing factors of early-onset T2DM with MC.Methods:We selected 400 T2DM patients with a diagnosis age of ≥18 years who were admitted to the Endocrine Metabolism Department of the First Affiliated Hospital of Nanchang University from January 2020 to June 2022.Patients diagnosed with age 40 and below were classified as the early onset group(178 cases),while patients diagnosed with age 40 and above were classified as the late onset group(222 cases).The incidence of MC,TIR,general characteristics,and laboratory data were compared between the early onset group and the late onset group;In the early onset group,subgroups were classified based on the presence or absence of MC.Among them,114 cases of early onset T2DM with MC were included,while 64 cases of early onset T2DM without MC were included.TIR,general characteristics,and laboratory data were compared between the two subgroups;In the subgroup of early-onset T2DM with MC,they were grouped according to the quartile of TIR;In the late onset group,subgroups were classified based on the presence or absence of MC.Among them,117 cases of late onset T2DM with MC were included,while 105 cases of late onset T2DM without MC were included.TIR,general characteristics,and laboratory data were compared between the two subgroups;Collect TIR and other indicators through FGM and wear them for 3 days or more.Collect clinical related indicators of all study subjects and analyze the data using SPSS software.Results:(1)Compared with the early onset group,patients in the late onset group had higher TIR,HDL-C,and SBP,more hypertension history,and gender differences,with more boys.However,TAR,TG,SUA,FPG,CP,HbAlc,1hCP were lower,and the number of family history of diabetes was lower(P<0.05).There was no statistically significant difference in BMI,course of disease,smoking history,drinking history,DBP,SCR,TG,LDL-C,UACR,1hCP,2hCP,and PG2h(P>0.05),(2)The incidence of MC in the early onset group was 64%,while the incidence of MC in the late onset group was 52.7%(P=0.022),(3)In the early onset group,compared with the non-MC subgroup,the combined MC subgroup had a longer course of disease,higher SBP,DBP,TAR,and lower TIR(P<0.05).There was no significant difference between the two groups in diagnosis age,BMI,gender,smoking history,drinking history,hypertension history,diabetes family history,TBR,SCR,SUA,TG,TC,HDL-C,LDL-C,HbA1C,CP,1hCP,2hCP,FPG,PG1h PG2h(P>0.05),(4)The binary logistic regression results of the influencing factors of early-onset T2DM with MC showed that TIR(OR=0.976,95%CI:0.962-0.990,P=0.001)was an independent protective factor for early-onset T2DM with MC,while disease course(OR=0.213,95%CI:1.134-1.351,P<0.001)and SBP(OR=0.036,95%CI:1.004-1.070,P=0.028)were independent risk factors,(5)In the subgroup of early-onset T2DM combined with MC,early-onset T2DM combined with MC accounted for 64%of the total number of early-onset T2DM.In the quartile of TIR,the incidence of MC increased significantly with the decrease of TIR(P=0.004),(6)In the late onset group,compared with the non comorbid MC subgroup,the comorbid MC subgroup had a longer course of disease,more history of hypertension,And fewer people have a history of smoking,with lower TIR,1hCP,and 2hCP(P<0.05).No statistically significant difference was found between the two groups in age at diagnosis,BMI,DBP,TBR,SUA,TC,TG,HDLC,LDLC,HbA1C,CP,FPG,PG1h,PG2h,gender,drinking history,and diabetes family history(P>0.05),(7)The binary logistic regression results of the influencing factors of late onset T2DM with MC showed that SCR(OR=1.020,95%CI:1.007-1.034,P<0.05)was an independent risk factor.Conclusion:(1)The incidence of early onset T2DM with MC is higher than that of late onset T2DM with MC,(2)High TIR is an independent protective factor for the occurrence of MC in early-onset T2DM,while course of disease and SBP are independent risk factors for the occurrence of MC in early-onset T2DM.