Inverse association between glucose variability and body fat in type 2 diabetes with impaired endogenous insulin secretion assessed using continuous glucose monitoring: A prospective observational study

Aim: To evaluate the contribution of body fat mass and serum adiponectin concentration to glucose variability (GV) stability in people with type 2 diabetes with impaired versus preserved endogenous insulin secretion. Materials and methods: This multicentre prospective observational study included 193 people with type 2 diabetes who underwent ambulatory continuous glucose monitoring, abdominal computed tomography and fasting blood sampling. A fasting C-peptide (FCP) concentration >2 ng/mL was defined as preserved endogenous insulin secretion. The participants were divided into high (FCP > 2 ng/mL) and low FCP subgroups (FCP <= 2 ng/mL). Multivariate regression analysis was performed in each subgroup. Results: In the high FCP subgroup, the coefficient of variation (CV) in GV was unrelated to abdominal fat area. In the low FCP subgroup, a high CV was significantly related to small abdominal visceral fat area (beta = -0.11, standard error 0.03; P < 0.05) and to small subcutaneous fat area (beta = -0.09, standard error 0.04; P < 0.05). No significant relationship between serum adiponectin concentration and continuous glucose monitoring-related variables was found. Conclusions: The contribution of body fat mass to GV depends on the endogenous insulin secretion residue. A small body fat area has independent adverse effects on GV in people with type 2 diabetes and impaired endogenous insulin secretion.

Automated summary

This study evaluated the contribution of body fat mass and serum adiponectin concentration to glucose variability stability in people with impaired and preserved endogenous insulin secretion in type 2 diabetes. The results showed that in those with preserved endogenous insulin secretion, glucose variability was not related to abdominal fat area. However, in those with impaired endogenous insulin secretion, glucose variability was significantly related to small abdominal visceral fat area and small subcutaneous fat area. There was no significant relationship between serum adiponectin concentration and continuous glucose monitoring-related variables.