Quantitiative Analysis Research On Characteristics Of Dynamic Glucose Fluctuation

Glucose fluctuation of body produced in the regulation of glucose in the process.72 hours glucose series captured by continuous glucose monitoring system(CGMS)provides detailed information on glucose control and fluctuation.Techniques of signal analysis provide an approach to investigate the time-frequency characteristics of glucose fluctuation compare to traditional glucose fluctuation indices.In order to respect the glucose time series variability and complexity,we applied to the multiple scales analysis methods which are ensemble empirical mode decomposition(EEMD),multi-scale entropy(MSE),refined composite multi-scale entropy(RCMSE)and detrended fluctuation analysis(DFA)to explore the glycemic and complexity of glucose time series from multiple scales on the72 hours glucose time series with 98 Type 2 DM patients.We then quantified and compared the characteristics the continuous glucose time series between groups of type 2 DM subjects with different MAGE,HbA1 c and DP.And we tried to study the cardiopulmonary coupling(CPC)and heart rate variability(HRV)which associated with the glucose fluctuation,and compare the high frequency coupling,low frequency coupling,very low frequency coupling and the apnea-hyponea index(AHI).Results: With EEMD,glucose series was decomposed into several intrinsic mode function(IMF),subgroup with higher MAGE value(>3.9)presented higher glycemic baseline and variability on IMF3-5,the glucose fluctuation may be associated with postprandial rhythm,autonomic rhythms and sleep /wake behavior.The complexity of glucose series quantified by RCMSE and MSE showed that the complexity index of MAGE>3.9 is higher than MAGE?3.9,the short-term and long-term scale exponent of MAGE>3.9 is higher than MAGE?3.9,the complexity index and the scale exponent show that the glucose complexity of MAGE>3.9 is higher than MAGE?3.9,the sleep quality quantified by CPC method of MAGE>3.9 is worse than MAGE?3.9,MAGE>3.9 DM have higher AHI and very low frequency.The complexity of glucose time series quantified by RCMSE decreased with the increasing HbA1 c level but the entropy had no statistical difference among groups at different scales.The glucose complexity quantified by DFA increased with the increasing DP level but the scale exponent had no statistical difference among groups at the short-term and long-term scales.In a whole,the higher glucose fluctuation can make its glucose complexityimpaired.It was proved that glucose flucotuation exists multiple scale characteristic,the glucose fluctuation may be associated with postprandial rhythm,autonomic rhythms and sleep /wake behavior,less complexity of glucose dynamics could indicate the impaired gluco-regulation function and high glucose fluctuation degree from the MAGE point of view or HbA1 c or dawn phenomenon for patients,and the glucose complexity had the potential to become a new biomarker to reflect the fluctuation of the glucose series.The study on complexity of glucose fluctuation not only helps us understand the regulation of the glucose homeostasis system but also brings us a new insight of the research methodology on glucose regulation.Higher glucose fluctuation had effect on sleep,but their association would be explored in the future.