Defining the target value of the coefficient of variation by continuous glucose monitoring in Chinese people with diabetes
Yifei Mo, Xiaojing Ma, Jingyi Lu, Yun Shen, Yufei Wang, Lei Zhang, Wei Lu, Wei Zhu, Yuqian Bao, Jian Zhou
Abstract
Abstract Aims/Introduction To define the target value for the percentage coefficient of variation for glucose (%CV) as a measure of glycemic variability (GV) in Chinese diabetes patients. Materials and Methods This retrospective study included 3,007 diabetes patients who underwent continuous glucose monitoring for 3 days. Type 2 diabetes was divided into groups according to the received treatment: group 1, non‐insulinotropic agent ( n = 138); group 2, insulinotropic agent ( n = 761); group 3, basal insulin therapy ( n = 100); group 4, premixed insulin ( n = 784); and group 5, intensive insulin therapy ( n = 612). Type 1 diabetes patients were included as group 6 ( n = 612). %CV and percentage of time per day within, below (3.9mmol/L; TBR 3.9 ) and above (10.0 mmol/L) the target glucose range (3.9–10.0 mmol/L) were computed. TBR 3.9 ≥4% was defined as excessive hypoglycemia. Results Type 2 diabetes with a premixed or intensive insulin regimen had an increased %CV compared with those receiving oral therapy or basal insulin. The upper limit of %CV in group 1 was 33%, which was adopted as the threshold to define excessive GV. For each treatment group, the percentage of people with TBR 3.9 ≥4% was significantly greater in the subgroup with %CV >33% than ≤33% ( P < 0.001). In participants who achieved TBR 3.9 <4%, the time per day spent within the target glucose range of 3.9–10.0 mmol/L > 70% and time per day above 10.0 mmol/L <25%, the 95th percentile of %CV was 32.70%. Further receiver operating characteristic curve analysis showed that the cut‐off values of %CV for predicting TBR 3.9 ≥4% varied by the type of diabetes and glycated hemoglobin categories. Conclusions A %CV of 33% was set as the threshold for excess glucose variability in Chinese diabetes patients. Meanwhile, glycated hemoglobin and the type of diabetes should be considered for the goal‐setting of %CV.