| Objective In this study,patients with type 2 diabetes mellitus（T2DM）were choosed as subjects to analyze the correlation between time in range（TIR）and vibration perception threshold（VPT）;The calculation of TIR was based on blood glucose data obtained from capillary blood glucose monitoring.Methods 303 patients were selected as the research subject with T2DM who were hospitalized in the Geriatrics Department of Lanzhou University Second Hospital from August 2018 to April 2021.The general information and clinical information of all subjects were collected,including age,gender,body mass index（BMI）,duration of T2DM,blood glucose monitoring data,glycosylated hemoglobin（HbA1c）,insulin（INS）use,fasting insulin（FINS）,2h postprandial insulin（2 hINS）,blood lipids,uric acid（UA）,diabetic complications,hypertension history,smoking history,etc.The 7-point capillary blood glucose monitoring data were collected for 3days before 3 months（monitoring one day per month）and three consecutive days after admission.TIR,TAR,SDBG,LAGE and mPPGE were obtained by calculation.SPSS 24.0 software was used to Choose the suitable statistical process for statistical analysis of the data,P<0.05 was considered statistically significant.Results（1）Comparison of clinical datas and blood glucose fluctuation indexes of T2DM subjects with various VPT levels:according to the VPT level,the patients were separated into three groups.VPT:0～15 V was VSN group（n=66）,16～25 V was VSI group（n=95）,and>25 V was VSD group（n=142）.The comparison of clinical data of each group showed that compared with VSN group,the age,course of T2DM,triglyceride（TG）,HbA1c,fasting plasma glucose（FPG）,2-hour postprandial blood glucose（2hPG）,INS utilization rate in VSI and VSD groups increased,and total cholesterol（TC）decreased.The smoking rate,DN prevalence rate and DR prevalence rate in VSD group were increased.Compared with the VSI group,the age,duration of T2DM,HbA1c,FPG and INS utilization rate of VSD group were increased,and the above differences were statistically significant（P<0.05）.Comparison of glycemic variability indexes among the three groups showed that TIR,TAR,LAGE,SDBG and mPPGE in the three groups showed outstanding contrast（P<0.05）.With the enhance of VPT grade,TIR showed a downward trend,while TAR,LAGE,SDBG and mPPGE showed an upward trend.（2）Correlation analysis of VPT grade and other indexes in T2DM patients:Spearman correlation analysis was used to analyze the correlation between VPT level and TIR and other factors.The results showed that VPT grade of T2DM patients was positively correlated with age,T2DM course,TAR,SDBG,LAGE,mPPGE,HbA1c and TG（rs=0.512,0.592,0.842,0.568,0.518,0.388,0.654,0.273,P<0.05）,and were negatively correlated with TIR（rs=-0.844,P<0.05）,that is,the higher TIR level,the lower VPT grade of T2DM patients.（3）Regression analysis of influencing factors of VPT level in T2DM patients:With VPT level as the dependent variable,TIR,single factor analysis and meaningful indexes obtained from previous studies as independent variables,Stepwise multiple stepwise regression analysis was performed to show the results that TIR level was negatively correlated with VPT level（β=-15.868,95%CI:-18.332～-13.405,P<0.05）,indicating that the increase of TIR level was an independent protective factor for the increase of VPT level.Age（β=0.132,95%CI:0.062～0.203,P<0.05）,course of T2DM（β=0.149,95%CI:0.044～0.255,P<0.05）,HbA1c（β=0.594,95%CI:0.274～0.914,P<0.05）and TG（β=0.430,95%CI:0.135～0.726,P<0.05）were positively correlated with VPT level,and were independent risk factors for VPT.（4）Relationship between TIR levels and VPT levels in the group with or without insulin:linear regression analysis of TIR and VPT level was performed on143 cases in the group without insulin and 160 cases in the group with insulin,severally,and the results showed that TIR level was negatively correlated with VPT level regardless of whether insulin was used or not（P<0.05）.（5）Effects of age and T2DM course on the relationship between TIR and VPT:Linear regression analysis of TIR and VPT levels was carried out for elderly T2DM group（age≥60 years）,non-elderly T2DM group（age<60 years）,T2DM group（duration≥10 years）and T2DM group（duration<10 years）respectively.After gradual adjustment for confounding factors,the results showed that whether the patients were older than 60 years and the duration of T2DM was longer than 10years,TIR was negatively correlated with VPT（P<0.05）.（6）Comparison of clinical data of different TIR grading groups:303 T2DM patients were separated into three groups in accordance with TIR level,including 95cases in the TIR≤40%group（group A）,104 cases in the 41%～70%group（group B）,and 104 cases in the TIR≥71%group（group C）.The VPT levels of the three groups showed significant differences（P<0.05）.With the increase of TIR grade,the levels of VPT showed a downward trend.The biochemical indexes and clinical data of each group were contrasted and the results displayed that:compared with group A,the course of disease,fasting blood glucose,VPT,TAR,SDBG,LAGE,HbA1C,INS utilization rate and the prevalence of DN were decreased in group B and group C,while the age,2hPG,mPPGE,smoking rate and the prevalence of DR were decreased in group C,while BMI and UA were increased.Compared with group B,age,course of disease,FBG,2hPG,VPT,TAR,SDBG,LAGE,mPPGE,HbA1C,HDL and INS utilization rates in group C were decreased.The differences were statistically significant（P<0.05）.（7）Correlation analysis between TIR grade and VPT grade,DR and DN prevalence:Spearman correlation analysis was used to determine whether TIR grade was correlated with VPT grade,prevalence of DR and DN.The results showed that TIR grade was negatively correlated with VPT grade,prevalence of DR and DN（rs=-0.831,-0.198,-0.231,P<0.05）.That is,The higher TIR grade,the lower VPT grade,DR prevalence and DN prevalence.（8）Comparison of VPT between whether TIR and TAR compliance group:According to whether TIR>70%,303 patients with T2DM were divided into TIR compliance group and TIR non-compliance group.Based on whether TAR<25%,303patients with T2DM were allocated to TAR compliance group and TAR non-compliance group.Comparison of the VPT levels among groups separately:The TIR standard group was smaller than the TIR non-standard group,the TAR standard group was smaller than the TAR non-standard group,and the diversity was statistically significant（P<0.05）.Conclusion（1）TIR is calculated by blood glucose data monitored by capillary blood glucose and is correlated with VPT grade in T2DM patients.The more times blood glucose reache the standard,the less severe diabetic peripheral neuropathy（DPN）is.（2）VPT level is lower in T2DM patients with TIR and TAR standards.Control of TIR and TAR standards can delay the progression of DPN. |
