Association of Body Fat Percentage with Time in Range Generated by Continuous Glucose Monitoring During Intensive Insulin Pump Therapy in Type 2 Diabetes
Obese individuals have nearly five times high risk to develop diabetes and maintain glycemic control as compared to normal-weight individuals. Even though body fat percentage is used in assessing body composition, the association between body fat percentage and glycemic control in T2DM remains unknown. There is increasing interest in time in range (TIR) assessed by CGM but still, there is little insight into the relationship between body composition and TIR during short-term intensive insulin pump therapy. Yuting ruan and colleague have conducted a study under the title “Association of Body Fat Percentage with Time in Range Generated by Continuous Glucose Monitoring During Intensive Insulin Pump Therapy in Type 2 Diabetes” published in Research Square. The summary of this study is given below:
Objective:
To evaluate the association of body fat percentage with TIR assessed by CGM in T2DM patients during short-term intensive insulin pump therapy.
Method:
TIR was defined as the percentage of time spent between the target glucose range of 3.9-10.0 mmol/L. 85 T2DM patients have participated in this cross-sectional study. All participants underwent a 72-h CGM period during intensive insulin pump therapy. Bioelectrical impedance analysis (BIA) was used to assess body composition. Body fat of at least 30% of total body mass for women or at least 25% for men is defined as overfat. In order to assess the independent association of body fat percentage with TIR, multiple linear regression models were used after adjusting for confounding factors.
Findings:
The study concludes that body composition mainly high body fat percentage may independently contribute to reduced TIR in the obese T2DM population. Additionally, it is found that fat accumulation in obese T2DM patients can be the main cause of poor glycemic control. In T2DM who fail to achieve optimal glycemic control, intensive insulin pump therapy is of great importance. As compare to non-obese patients, higher levels of 72-h mean blood glucose (MBG) were demonstrated in obese T2DM patients during insulin pump therapy. However, the decreased glycemic variability coefficient of variation (CV) was observed in patients with high body fat percentages.
Limitation:
The causal relationship between body composition and TIR was not examined due to the cross-sectional nature of the study. Secondly, 72-h period measurement of TIR for a may not represent the glycemic control of the participants during the whole period of intensive insulin pump therapy. The authors suggest being precautious while applying the findings to a larger population due to the small sample size of this study. Lastly, BIA was used to assess body composition over expensive methods such as computer tomography (CT) and Magnetic resonance imaging (MRI).
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