Decreasing complexity of glucose time series derived from continuous glucose monitoring is correlated with deteriorating glucose regulation

Abstract

Most information used to evaluate diabetic statuses is collected at a special time-point, such as taking fasting plasma glucose test and providing a limited view of individual’s health and disease risk. As a new parameter for continuously evaluating personal clinical statuses, the newly developed technique “continuous glucose monitoring” (CGM) can characterize glucose dynamics. By calculating the complexity of glucose time series index (CGI) with refined composite multi-scale entropy analysis of the CGM data, the study showed for the first time that the complexity of glucose time series in subjects decreased gradually from normal glucose tolerance to impaired glucose regulation and then to type 2 diabetes (P for trend < 0.01). Furthermore, CGI was significantly associated with various parameters such as insulin sensitivity/secretion (all P < 0.01), and multiple linear stepwise regression showed that the disposition index, which reflects β-cell function after adjusting for insulin sensitivity, was the only independent factor correlated with CGI (P < 0.01). Our findings indicate that the CGI derived from the CGM data may serve as a novel marker to evaluate glucose homeostasis.

Keywords

complexity of glucose time series / continuous glucose monitoring / impaired glucose regulation / insulin secretion and sensitivity / refined composite multi-scale entropy

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Acknowledgements

This work was funded by the National Natural Science Foundation of China (Nos. 81873646 and 61903071), the Shanghai United Developing Technology Project of Municipal Hospitals (Nos. SHDC12006101 and SHDC12010115), the Shanghai Municipal Education Commission Gaofeng Clinical Medicine grant support (Nos. 20161430). We thank all the involved clinicians, nurses, and technicians for their contribution to the study and all the participants for their participation. A list of participating investigators is available in the Appendix in the Supplementary Material.

Electronic Supplementary Material

Supplementary material is available in the online version of this article at https://doi.org/10.1007/s11684-022-0955-9 and is accessible for authorized users.

Compliance with ethics guidelines

Cheng Li, Xiaojing Ma, Jingyi Lu, Rui Tao, Xia Yu, Yifei Mo, Wei Lu, Yuqian Bao, Jian Zhou and Weiping Jia declare that they have no conflict of interest. All authors meet the International Committee of Medical Journal Editors criteria for authorship of this article and take responsibility for the integrity of the work as a whole. All authors have given approval for this version to be published. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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