Skip to main content
Top
Published in: Endocrine 1/2024

Open Access 05-12-2023 | Type 1 Diabetes | Original Article

Association of glycemic variability and time in range with lipid profile in type 1 diabetes

Authors: Mariana Salsa-Castelo, Celestino Neves, João Sérgio Neves, Davide Carvalho

Published in: Endocrine | Issue 1/2024

Login to get access

Abstract

Purpose

Hyperglycemia is associated with abnormalities of lipoproteins. The aim of this study was to analyze, in patients with Type 1 Diabetes (T1D), the association of glycemic control with lipid profile, focusing on glycemic variability and time in range obtained from Continuous Glucose Monitoring (CGM).

Methods

We performed a retrospective cohort in patients with T1D. We analyzed clinical parameters, HbA1c, CGM and lipid profile in two moments 6 to 18 months apart. We evaluated the association of HbA1c and CGM metrics with lipid profile in cross-sectional (n = 242) and longitudinal (n = 90) analyses.

Results

The mean age of the study population was 36.6 ± 12.6 years, 51.7% were male, and the mean diabetes duration was 16.8 ± 10.3 years. In the cross-sectional analysis, higher HbA1c, higher glucose management indicator (GMI), higher time above range and lower time in range were associated with higher triglyceride levels. In the longitudinal analysis, an increase in time below range was associated with a decrease of HDL cholesterol. In both analyses, an increase in the coefficient of variability (CV) was associated with a significant decrease of HDL cholesterol. HbA1c and CGM were not associated with total cholesterol or LDL cholesterol.

Conclusions

We observed a negative association between CV and HDL cholesterol levels and a positive association between hyperglycemia metrics and triglyceride levels. These findings suggest that CGM parameters may be a helpful tool to guide the improvement of both glycemic control and lipid profile in T1D.
Appendix
Available only for authorised users
Literature
1.
go back to reference M. Lind et al. Glycemic control and excess mortality in type 1 diabetes. N. Engl. J. Med. 371(21), 1972–1982 (2014)CrossRefPubMed M. Lind et al. Glycemic control and excess mortality in type 1 diabetes. N. Engl. J. Med. 371(21), 1972–1982 (2014)CrossRefPubMed
2.
go back to reference Group, D.C.a.C.T.E.o.D.I.a.C.D.E.R., Risk Factors for Cardiovascular Disease in Type 1. Diabetes. Diabetes 65(5), 1370–1379 (2016)CrossRef Group, D.C.a.C.T.E.o.D.I.a.C.D.E.R., Risk Factors for Cardiovascular Disease in Type 1. Diabetes. Diabetes 65(5), 1370–1379 (2016)CrossRef
3.
go back to reference B. Vergès, Dyslipidemia in Type 1 Diabetes: AMaskedDanger. Trends Endocrinol. Metab. 31(6), 422–434 (2020)CrossRefPubMed B. Vergès, Dyslipidemia in Type 1 Diabetes: AMaskedDanger. Trends Endocrinol. Metab. 31(6), 422–434 (2020)CrossRefPubMed
4.
go back to reference J. Guy et al. Lipid and lipoprotein profiles in youth with and without type 1 diabetes: the SEARCH for Diabetes in Youth case-control study. Diabetes Care 32(3), 416–420 (2009)CrossRefPubMedPubMedCentral J. Guy et al. Lipid and lipoprotein profiles in youth with and without type 1 diabetes: the SEARCH for Diabetes in Youth case-control study. Diabetes Care 32(3), 416–420 (2009)CrossRefPubMedPubMedCentral
5.
go back to reference D.M. Maahs et al. Association of glycaemia with lipids in adults with type 1 diabetes: modification by dyslipidaemia medication. Diabetologia 53(12), 2518–2525 (2010)CrossRefPubMedPubMedCentral D.M. Maahs et al. Association of glycaemia with lipids in adults with type 1 diabetes: modification by dyslipidaemia medication. Diabetologia 53(12), 2518–2525 (2010)CrossRefPubMedPubMedCentral
7.
go back to reference I.H.S. Group, Hypoglycaemia, cardiovascular disease, and mortality in diabetes: epidemiology, pathogenesis, and management. Lancet Diabetes Endocrinol. 7(5), 385–396 (2019)CrossRef I.H.S. Group, Hypoglycaemia, cardiovascular disease, and mortality in diabetes: epidemiology, pathogenesis, and management. Lancet Diabetes Endocrinol. 7(5), 385–396 (2019)CrossRef
8.
go back to reference T.S. Temelkova-Kurktschiev et al. Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose or HbA1c level. Diabetes Care 23(12), 1830–1834 (2000)CrossRefPubMed T.S. Temelkova-Kurktschiev et al. Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose or HbA1c level. Diabetes Care 23(12), 1830–1834 (2000)CrossRefPubMed
9.
go back to reference M.C. Nwadiugwu, et al. Identifying Glycemic Variability in Diabetes Patient Cohorts and Evaluating Disease Outcomes. J. Clin. Med. 10, 1477 (2022)CrossRef M.C. Nwadiugwu, et al. Identifying Glycemic Variability in Diabetes Patient Cohorts and Evaluating Disease Outcomes. J. Clin. Med. 10, 1477 (2022)CrossRef
10.
go back to reference Committee, A.D.A.P.P Glycemic Targets: Standards of Medical Care in Diabetes—2022. Diabetes Care 45(Supplement_1), S83–S96 (2021) Committee, A.D.A.P.P Glycemic Targets: Standards of Medical Care in Diabetes—2022. Diabetes Care 45(Supplement_1), S83–S96 (2021)
11.
go back to reference S.M. Haffner, Do interventions to reduce coronary heart disease reduce the incidence of type 2 diabetes? A possible role for inflammatory factors. Circulation 103(3), 346–347 (2001)CrossRefPubMed S.M. Haffner, Do interventions to reduce coronary heart disease reduce the incidence of type 2 diabetes? A possible role for inflammatory factors. Circulation 103(3), 346–347 (2001)CrossRefPubMed
12.
go back to reference K. Esposito et al. Regression of carotid atherosclerosis by control of postprandial hyperglycemia in type 2 diabetes mellitus. Circulation 110(2), 214–219 (2004)CrossRefPubMed K. Esposito et al. Regression of carotid atherosclerosis by control of postprandial hyperglycemia in type 2 diabetes mellitus. Circulation 110(2), 214–219 (2004)CrossRefPubMed
13.
go back to reference L. Monnier et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. Jama 295(14), 1681–1687 (2006)CrossRefPubMed L. Monnier et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. Jama 295(14), 1681–1687 (2006)CrossRefPubMed
14.
go back to reference D.J. Cox et al. Frequency of severe hypoglycemia in insulin-dependent diabetes mellitus can be predicted from self-monitoring blood glucose data. J. Clin. Endocrinol. Metab. 79(6), 1659–1662 (1994)PubMed D.J. Cox et al. Frequency of severe hypoglycemia in insulin-dependent diabetes mellitus can be predicted from self-monitoring blood glucose data. J. Clin. Endocrinol. Metab. 79(6), 1659–1662 (1994)PubMed
15.
go back to reference A. Pérez et al. Prevalence and phenotypic distribution of dyslipidemia in type 1 diabetes mellitus: effect of glycemic control. Arch. Intern. Med. 160(18), 2756–2762 (2000)CrossRefPubMed A. Pérez et al. Prevalence and phenotypic distribution of dyslipidemia in type 1 diabetes mellitus: effect of glycemic control. Arch. Intern. Med. 160(18), 2756–2762 (2000)CrossRefPubMed
16.
go back to reference R. Huang, L. Yan, Y. Lei, The relationship between high-density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin in diabetic patients aged 20 or above: a cross-sectional study. BMC Endocr. Disord. 21(1), 198 (2021)CrossRefPubMedPubMedCentral R. Huang, L. Yan, Y. Lei, The relationship between high-density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin in diabetic patients aged 20 or above: a cross-sectional study. BMC Endocr. Disord. 21(1), 198 (2021)CrossRefPubMedPubMedCentral
17.
18.
go back to reference S.T. O’Brien, O.M. Neylon, T. O’Brien, Dyslipidaemia in Type 1 Diabetes: Molecular Mechanisms and Therapeutic Opportunities. Biomedicines 9, 826 (2021)CrossRefPubMedPubMedCentral S.T. O’Brien, O.M. Neylon, T. O’Brien, Dyslipidaemia in Type 1 Diabetes: Molecular Mechanisms and Therapeutic Opportunities. Biomedicines 9, 826 (2021)CrossRefPubMedPubMedCentral
19.
go back to reference I.J. Goldberg, Diabetic Dyslipidemia: Causes and Consequences. J. Clin. Endocrinol. Metab. 86(3), 965–971 (2001)CrossRefPubMed I.J. Goldberg, Diabetic Dyslipidemia: Causes and Consequences. J. Clin. Endocrinol. Metab. 86(3), 965–971 (2001)CrossRefPubMed
20.
go back to reference V.A. Koivisto et al. Cardiovascular Disease and Its Risk Factors in IDDM in Europe. Diabetes Care 19(7), 689–697 (1996)CrossRefPubMed V.A. Koivisto et al. Cardiovascular Disease and Its Risk Factors in IDDM in Europe. Diabetes Care 19(7), 689–697 (1996)CrossRefPubMed
21.
go back to reference Committee, A.D.A.P.P, Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2022. Diabetes Care 45(Supplement_1), S144–S174 (2021) Committee, A.D.A.P.P, Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2022. Diabetes Care 45(Supplement_1), S144–S174 (2021)
22.
go back to reference H. Cardoso, et al. National Consensus in the use of the Flash Glucose Monitoring System in Portugal. Rev. Port. Endocrinol. Diabetes Metab. 14(1), 74–81 (2019) H. Cardoso, et al. National Consensus in the use of the Flash Glucose Monitoring System in Portugal. Rev. Port. Endocrinol. Diabetes Metab. 14(1), 74–81 (2019)
Metadata
Title
Association of glycemic variability and time in range with lipid profile in type 1 diabetes
Authors
Mariana Salsa-Castelo
Celestino Neves
João Sérgio Neves
Davide Carvalho
Publication date
05-12-2023
Publisher
Springer US
Published in
Endocrine / Issue 1/2024
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-023-03464-x

Other articles of this Issue 1/2024

Endocrine 1/2024 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.