Key result
IGT exhibits a lower short-term complexity exponent α1 versus mild and overt DM.
Why the study?
This study clarified whether detrended fluctuation analysis (DFA) can evaluate the progressive loss of glucose complexity from impaired glucose tolerance through mild to overt diabetes mellitus.
Does detrended fluctuation analysis of continuous glucose monitoring data differentiate between impaired glucose tolerance, mild diabetes mellitus, and overt diabetes mellitus?
Observational (n=59)
Yes
Does detrended fluctuation analysis of continuous glucose monitoring data differentiate between impaired glucose tolerance, mild diabetes mellitus, and overt diabetes mellitus?
p-value: p=<0.0001
Detrended fluctuation analysis of continuous glucose monitoring data demonstrates progressive loss of short-term glucose complexity as patients progress from impaired glucose tolerance to overt diabetes mellitus.
No immediate change to IGT monitoring; leaves open validation of α1 for dysglycemia staging.
BACKGROUND: This study clarified whether detrended fluctuation analysis (DFA) can evaluate how to advance the loss of complexity from impaired glucose tolerance (IGT) through mild diabetes mellitus (DM) to overt DM. METHODS: Continuous glucose monitoring (CGM) was done during a 48-h interval for 59 subjects from multiple centers. Subjects were divided according to CGM data into those with impaired glucose tolerance (IGT) (n = 20), mild DM (n = 13), and overt DM (n = 26). The short-term (α1) and long-term (α2) range exponentials by DFA were compared among the three groups. RESULTS: The value of α1 within 1h was significantly lower in the IGT group than in either of the other two groups (IGT vs. mild DM vs. overt DM, 1.53 ± 0.22 vs. 1.71 ± 0.17 vs. 1.77 ± 0.13, P<0.0001), and α1 within 2h differed significantly among the three groups (1.49 ± 0.13 vs. 1.57 ± 0.10 vs. 1.72 ± 0.10, P<0.0001). The α1 within 3h was significantly higher in overt DM than in either of the other two groups but did not change between IGT and mild DM (1.44 ± 0.12 vs. 1.52 ± 0.11 vs. 1.67 ± 0.09, P<0.0001). All short-term exponents decreased gradually but significantly as the window widened in all groups (P<0.0001). The α2 over 1h was significantly higher in overt DM but was unchanged in IGT and mild DM (1.22 ± 0.11 vs. 1.27 ± 0.12 vs. 1.36 ± 0.13, P = 0.0010). The α2 over 3h did not differ among the three groups. CONCLUSIONS: Progressive loss of complexity in the glycemic profile occurred from the short-term range and spread to the long-term range concomitantly with the progression of the DM state.
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Yamamoto et al. (2010) conducted an observational in Impaired glucose tolerance and diabetes mellitus (n=59). Diabetes mellitus progression state vs. Impaired glucose tolerance was evaluated on Short-term (α1) and long-term (α2) range exponentials by detrended fluctuation analysis (p=<0.0001). The short-term complexity exponent α1 within 1h was significantly lower in impaired glucose tolerance compared to mild and overt diabetes (1.53 vs 1.71 vs 1.77, P<0.0001).
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