Association of Body Fat Percentage with Time in Range Generated by Continuous Glucose Monitoring during Continuous Subcutaneous Insulin Infusion Therapy in Type 2 Diabetes

Abstract

Background. Obesity is a crucial risk factor associated with type 2 diabetes mellitus (T2DM). Excessive accumulation of body fat may affect the glycemia control in T2DM. This study investigated the relationship between body fat percentage and time in range (TIR) assessed by continuous glucose monitoring (CGM) during short-term continuous subcutaneous insulin infusion (CSII) therapy in T2DM patients. Method. A total of 85 T2DM patients were recruited in this cross-sectional study. All participants underwent 72 h CGM period during short-term CSII therapy. TIR was defined as the percentage of time spent within the target glucose range of 3.9-10.0 mmol/L. Body composition was measured using bioelectrical impedance analysis (BIA) and overfat was defined as an amount of body fat of at least 25% of total body mass for men or at least 30% for women. Multiple linear regression models were used to evaluate the independent association of body fat percentage with TIR after adjusting for confounding factors. Results. Compared with normal fat T2DM patients, individual with a higher body fat percentage exhibited lower levels of TIR ( P = 0.004 ) and higher 72 h mean blood glucose (72 h MBG) ( P = 0.001 ) during short-term CSII treatment. The prevalence of overfat assessed by body fat percentage decreased with the ascending TIR tertiles ( P < 0.05 ). Multiple linear regression analysis indicated that body fat percentage was significantly associated with TIR independent of age, gender, diabetes duration, HbA1c, and BMI ( P = 0.043 ). Conclusions. Body fat percentage was significantly associated with TIR in T2DM during short-term CSII therapy. Reduction of body fat may be an important therapeutic target to improve glycemic control in high body fat T2DM patients, who may benefit less from intensive insulin treatment.

Relationship of anthropometric measurements with glycated hemoglobin and 1‐h blood glucose after 50 g glucose challenge test in pregnant women: A longitudinal cohort study in Southern Thailand

“…To date, only one cross‐sectional study done in China has reported the association between HbA1c and body fat percentage in T2DM patients on insulin therapy. In this study, a Jawon bioelectrical impedance analyzer (BIA) was used to measure body fat percentage, and a high average HbA1c level was found when compared to our study 41 . Similarly, the subscapular skinfold thickness has been suggested as a potentially useful screening tool to measure the risk of becoming obese in female adults 42 …”

“…In this study, a Jawon bioelectrical impedance analyzer (BIA) was used to measure body fat percentage, and a high average HbA1c level was found when compared to our study. 41 Similarly, the subscapular skinfold thickness has been suggested as a potentially useful screening tool to measure the risk of becoming obese in female adults. 42 To date, we could not find the studies reporting the effects of body fat percentage or subscapular skinfold thickness to HbA1c or 1-h 50 g GCT in screening GDM in pregnant women.…”

Longitudinal relationship between body fat percentage and risk of type 2 diabetes in Chinese adults: Evidence from the China Health and Nutrition Survey

“…However, elevated BF% is not included in conditions recommended for screening T2D in the Chinese guideline ( 20 ). Of note, a cross-sectional study conducted by Ruan et al with 85 T2D patients in China, indicated that reducing body fat was an important adjuvant therapy to improve glycemic control among T2D patients with high body fat ( 42 ). Therefore, cost-effective actions to maintain appropriate body fat levels and preventing diabetes, such as specific nutrition education, clinical application of BF% based on sex, and lifestyle intervention included targeting diet and physical activity, are meaningful to take to reduce the disease burden related to T2D in the Chinses healthcare setting.…”

Diabetes Complications and Related Comorbidities Impair the Accuracy of FreeStyle Libre, a Flash Continuous Glucose Monitoring System, in Patients with Type 2 Diabetes

“…Self-monitoring of blood glucose (SMBG) is an integral component of diabetes management that aims to improve glycemic control and decrease the risk of diabetes-related complications. [1][2][3] Blood glucose monitoring system (BGMS), including real-time continuous glucose monitoring (CGM) and intermittently scanned CGM (also known as flash continuous glucose monitoring systems, FCGM), can provide continuous measurements of glucose levels and thereby aid diabetes patients in the adjustment of their diet, physical activity, and treatment regimen. 4,5 Any error in the BGMS, including slight inaccuracies in the measurements, could adversely affect patient care and treatment.…”