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A comparison of daily glucose fluctuation among GCK-MODY and type 2 diabetes using continuous glucose monitoring technology

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posted on 2023-03-20, 14:56 authored by Qian Ren, Ping Zhang, Wuyan Pang, Yumin Ma, Siqian Gong, Tianhao Ba, Wei Liu, Fang Zhang, Xiuying Zhang, Rui Zhang, Xiangqing Wang, Xiaomei Zhang, Wenjia Yang, Fang Lv, Leili Gao, Xueyao Han, Linong Ji

  

Glucokinase variant-induced maturity-onset diabetes of the young (GCK-MODY) exhibits the unique clinical features of mild fasting hyperglycaemia. However, formal studies of its glucose excursion pattern in daily life in comparison with those with or without other types of diabetes are lacking. We conducted a case-control study including 25 patients with GCK-MODY, 25 A1c-matched, drug naive patients with type 2 diabetes (T2DM) and 25 age-, BMI- and sex-matched subjects with normal glucose tolerance (NGT). All the subjects wore flash glucose monitoring (FGM) sensors for 2 weeks, and glucose readings were masked. Glucose excursion was significantly lower in the GCK-MODY than that in A1c-matched T2DM during the daytime, but was similar during the nighttime. The daytime coefficient of variation [CV] driven by postprandial glucose could separate GCK-MODY from well-controlled T2DM, but the nighttime CV could not. In discriminating between GCK-MODY and T2DM, the area under the curve (AUC) of the CV was 0.875. However, in GCK-MODY and NGT subjects, the CVs were similar at 24h, whereas the other four excursion parameters were significantly higher in GCK-MODY than those in NGT subjects. FGM confirmed the stability and mildness of hyperglycemia in GCK-MODY patients. Postprandial regulation is a key driver of the difference in excursion between GCK-MODY and T2DM.

Funding

X.H. has received grants from Beijing Municipal Commission of Science and Technology [Grant Number: Z201100005520012 and D131100005313008] (Clinical data collection, patient recruitment); L.J. has received grants from the National Key Research and Development Program [grant number 2016YFC1304901] (Genetic testing, patient recruitment).

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