The Correlation Of Glycemic Variability And 1,5-anhydroglucitol With Acute-phase Insulin Secretion In Patients With Type 2 Diabetes

Objective:The study sought to examine the association of various indices ofβ-cell function with glycemic variability in Chinese insulin-treated patients with type 2 diabetes and the association of 1,5-AG with acute C peptide response（ACPR）to arginine among patients with type 2 diabetes.Methods:This clinical study first carried out in 507 hospitalized insulin-treated patients with type 2 diabetes.Glycemic variability was assessed from continuous glucose monitoring data recorded over 3 days by calculating the mean coefficient of variation（CV）,and a cutoff value of CV≥36%was used to define unstable glucose.β-cell function was assessed by including basalβ-cell function and postloadβ-cell function.Basalβ-cell function obtained by fasting C-peptide（FCP）and the homeostasis model assessment 2 for b-cell function（HOMA2-%β）.Postloadβ-cell function assessed by 2-hour C-peptide（2h CP）as well as the ACPR calculated by the means of the arginine stimulation tests（AST）,in which ACPR was calculated as the mean C-peptide at 2,4,and 6 minutes minus the baseline C-peptide value.Secondly,we evaluated the relationship between 1,5-AG and the acute phase secretory function of isletβ-cell among 623 patients with type 2 diabetes.Impairedβ-cell function was defined as ACPR<2.1 ng/m L.Results:（1）Results found in 507 insulin-treated patients with type 2 diabetes,（1）ACPR,FCP and 2h CP decreased across quartiles of CV（for all trends,P<0.01）;（2）The multivariable-adjusted odds ratio for labile glycemic control show that only ACPR was a significant and inverse predictor for labile glycemic control;（3）Multivariable-adjusted odds ratio for labile glycemic control of FCP,2h CP and HOMA2-%βdid not reach statistical differences considered neither as quartiles nor as continuous variables（all P>0.05）.（2）（1）ACPR increased across quartiles of 1,5-AG（P for trend<0.001）;（2）Multivariable adjusted odds ratios for impairedβ-cell function across quartiles of 1,5-AG were decreased(P_trend=0.042);（3）Multivariate linear regression analysis showed that1,5-AG was one of the independent impacting factors of ACPR.Conclusions:ACPR evaluated by the arginine stimulation tests may be superior to FCP,2h CP and ACPR in reflecting glucose instability in insulin-treated patients with type 2diabetes.Furthermore,we found a graded negative association between 1,5-AG and the risk of acute phaseβ-cell function.