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Associations of serum glucagon levels with glycemic variability in type 1 diabetes with different disease durations

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Abstract

Purpose

Glucagon has been recognized as a pivotal factor implicated in the pathophysiology ofdiabetes. The purpose of this study is to investigate the dynamic secretion levels of serum glucagon (GLA) in patients with type 1 diabetes mellitus (T1DM) with different courses of disease, and to analyze its correlation with blood glucose fluctuation.

Methods

This observational study included 55 T1DM patients and divided into 3 groups according to the courses of disease. Group 1(the disease duration <1 year), Group 2(1≤the disease durations≤5), 3(the disease durations >5 years). All patients underwent a 100g standard steamed buns meal test,measuring the levels of serum glucose, glucagon, insulin, C-peptide in different points of time, and 48 of the total patients used continuous glucose monitoring system (CGMS) to monitor blood glucose.

Results

The fasting glucagon level in Group 1 was significantly higher than it in Group 2. Furthermore, the GLA1h, the GLA3h and the AUCGLA0-3h in Group 1 were greatly larger than those in Group 3. Referring to glycemic variability, the LBGI, AUC of hypoglycemia, the percentage of hypoglycemia time andthe times of nocturnal hypoglycemia in Group 1 were significantly lower than those in Group 3. Moreover,the fasting glucagon level was the independent factors to SD and MAGE. The AUCGLA0-3h were negatively correlated with MODD, LBGI, GRADE-hypo and AUC of nocturnal hypoglycemia.

Conclusions

It is concluded that glucagon secretory function impairs with duration of type 1 diabetes extended and correlates to glycemic fluctuation, especially hypoglycemia.

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Acknowledgements

This study was supported by National Natural Science Foundation of China (No. 81471018 and No. 81774134), Jiangsu Provincial Natural Science Foundation (No. BK20150558), Jiangsu Provincial Postdoctoral Foundation (No. 1501120C).

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    Authors and Affiliations

    1. Department of Endocrinology, Jinling Hospital, Southern Medical University, 305 Zhongshan East Road, Nanjing, Jiangsu Province, 210002, China

      Ke Li, Wen-jing Song, Pu Zang, Ping Gu, Bin Lu & Jia-qing Shao

    2. Department of Endocrinology, Jinling Hospital, Nanjing Medical University, 305 Zhongshan East Road, Nanjing, Jiangsu Province, 210002, China

      Xia Wu & Dan-yang Gu

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    1. Ke Li
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    Correspondence to Bin Lu or Jia-qing Shao.

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    These authors contributed equally: Ke Li, Wen-jing Song.

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    Li, K., Song, Wj., Wu, X. et al. Associations of serum glucagon levels with glycemic variability in type 1 diabetes with different disease durations. Endocrine 61, 473–481 (2018). https://doi.org/10.1007/s12020-018-1641-1

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    • DOI: https://doi.org/10.1007/s12020-018-1641-1

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