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已发表论文
2 型糖尿病患者血糖波动相关因素：一项基于连续血糖监测的回顾性观察研究
Authors Zhong N, Zhang A, Chen J, Hu Z, Nie R, Huang J, Wu M, Pan H
Received 6 June 2025
Accepted for publication 18 October 2025
Published 5 November 2025 Volume 2025:18 Pages 4049—4057
DOI https://doi.org/10.2147/DMSO.S542547
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Ernesto Maddaloni
Ni Zhong,1 Ao Zhang,1 Jiashen Chen,1 Zihan Hu,1 Renshan Nie,2 Jinzhu Huang,2 Meifen Wu,2 Haiyan Pan1,2
1School of Public Health, Guangdong Medical University, Dongguan, Guangdong, People’s Republic of China; 2Department of Endocrinology, the First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, Guangdong, People’s Republic of China
Correspondence: Haiyan Pan, Email panhaiyan@gdmu.edu.cn Meifen Wu, Email wmf923@126.com
Objective: To investigate the factors associated with glucose fluctuations in patients with type 2 diabetes mellitus (T2DM) using continuous glucose monitoring (CGM).
Methods: This retrospective observational study included 252 patients with T2DM who underwent CGM during hospitalization. Participants were stratified into two groups based on their coefficient of variation (CV) of glucose: the high-CV group (CV ≥ 33%, n=53) and the low-CV group (CV < 33%, n=199). Glucose fluctuation indices were calculated from CGM data. All patients underwent 3-day CGM during hospitalization. General clinical data and biochemical indicators were collected. Statistical analyses included t-tests, Mann–Whitney U-tests, logistic regression, and restricted cubic spline models.
Results: Significant differences were observed between the two groups in terms of disease duration, BMI, triglycerides, and C-peptide levels (P< 0.05). Compared to the low-CV group, patients in the high-CV group had significantly lower Time in Range (TIR) and higher Time Above Range (TAR) and Time Below Range (TBR) (all P< 0.001).
Multivariate Logistic regression analysis revealed that low BMI, low C-peptide, and longer disease duration may be risk factors for abnormal blood glucose fluctuations in T2DM patients (P< 0.05). Linear regression revealed a significant negative correlation between C-peptide levels and CV (β = -0.02, P=0.003).
A threshold effect was observed between C-peptide and the coefficient of variation(CV) of blood glucose (Cut-off=0.913 nmol/L), with CV increasing by 0.07 per 1 nmol/L decrease in C-peptide below this threshold (P=0.029).
Conclusion: This study suggests that patients with longer disease duration, lower BMI, and poorer pancreatic function have higher odds of significant glucose fluctuations. Enhanced monitoring of glucose fluctuations and education on potential risks are recommended for these subgroups to improve self-management abilities.
Keywords: type 2 diabetes mellitus, glucose fluctuation, continuous glucose monitoring, coefficient of variation, time in range
1School of Public Health, Guangdong Medical University, Dongguan, Guangdong, People’s Republic of China; 2Department of Endocrinology, the First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, Guangdong, People’s Republic of China
Correspondence: Haiyan Pan, Email panhaiyan@gdmu.edu.cn Meifen Wu, Email wmf923@126.com
Objective: To investigate the factors associated with glucose fluctuations in patients with type 2 diabetes mellitus (T2DM) using continuous glucose monitoring (CGM).
Methods: This retrospective observational study included 252 patients with T2DM who underwent CGM during hospitalization. Participants were stratified into two groups based on their coefficient of variation (CV) of glucose: the high-CV group (CV ≥ 33%, n=53) and the low-CV group (CV < 33%, n=199). Glucose fluctuation indices were calculated from CGM data. All patients underwent 3-day CGM during hospitalization. General clinical data and biochemical indicators were collected. Statistical analyses included t-tests, Mann–Whitney U-tests, logistic regression, and restricted cubic spline models.
Results: Significant differences were observed between the two groups in terms of disease duration, BMI, triglycerides, and C-peptide levels (P< 0.05). Compared to the low-CV group, patients in the high-CV group had significantly lower Time in Range (TIR) and higher Time Above Range (TAR) and Time Below Range (TBR) (all P< 0.001).
Multivariate Logistic regression analysis revealed that low BMI, low C-peptide, and longer disease duration may be risk factors for abnormal blood glucose fluctuations in T2DM patients (P< 0.05). Linear regression revealed a significant negative correlation between C-peptide levels and CV (β = -0.02, P=0.003).
A threshold effect was observed between C-peptide and the coefficient of variation(CV) of blood glucose (Cut-off=0.913 nmol/L), with CV increasing by 0.07 per 1 nmol/L decrease in C-peptide below this threshold (P=0.029).
Conclusion: This study suggests that patients with longer disease duration, lower BMI, and poorer pancreatic function have higher odds of significant glucose fluctuations. Enhanced monitoring of glucose fluctuations and education on potential risks are recommended for these subgroups to improve self-management abilities.
Keywords: type 2 diabetes mellitus, glucose fluctuation, continuous glucose monitoring, coefficient of variation, time in range