Relationships between obesity, body composition and continuous glucose monitoring parameters in subjects with type 2 diabetes on insulin therapy

Background and aim: Insulin resistance often develops against the background of obesity and can modify daily blood glucose fluctuations in men and women with diabetes (DM). In this study we aimed to determine the relationships between obesity, body composition and daily dynamics of glucose, assessed by continuous glucose monitoring (CGM), in individuals with type 2 DM treated with insulin. Materials and Methods: One hundred and thirty sixpatients with type 2 diabetes treated with insulin were examined. Real-time and blinded CGM was performed in hospitalized patients. Time in ranges and a panel of parameters of glucose variability (GV) were identified from CGM recordings. Results: Subjects with obesity, as compared to those without, demonstrated significantly reduced Time Below Range, Low Blood Glucose Index, Lability Index, Men Absolute Glucose (all p <; 0.05) and a tendency to lower Mean Amplidude of Glucose Excursions (p = 0.08), higher glycated hemoglobin A1c (p = 0.07). There were negative correlations (all p <; 0.05) between total fat mass (FM) and Standard Deviation (r = -0.53), Mean Amplitude of Glucose Excursions(r = - 0.38), Lability Index (r = -0.51), HighBloodGlucose Index (r = -0.33), MAG (r = -0.57). Truncal FM, android and gynoid FM demonstrated negative correlations with these GV parameters also. Conclusions: These data demonstrate the association between obesity, body composition and CGM parameters in insulin-treated in type 2 DM patients. Reduced GV and diminished risk of hypoglycemia is associated the presence of obesity and accumulation of adipose tissue.