Journal of endocrinological investigation · 2026
Metabolomic signatures of glycemic control in type 1 diabetes: insights from continuous glucose monitoring.
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de Lope Quiñones Sara, Luque-Ramírez Manuel, Quintero Tobar Alejandra, Ruiz Cánovas José Manuel, Dorado Avendaño Beatriz, Escobar-Morreale Hector F, Nattero-Chávez Lía
Аннотация
PURPOSE: This study aimed to investigate the relationship between serum metabolomic profiles and continuous glucose monitoring (CGM) metrics in adults with type 1 diabetes (T1D), given that glycaemic control differences influence distinct metabolic pathways.
METHODS: In this cross-sectional study, 325 adults with T1D were evaluated. CGM metrics were derived from 14-day recordings. Participants were stratified by achievement of clinical glycaemic targets [time in range (TIR70-180) > 70%, coefficient of variation (CV) < 36%, and time below range (TBR < 70) < 5%] into "on-target" and "off-target" groups. Serum metabolomic profiles were quantified using proton nuclear magnetic resonance spectroscopy (1 H-NMR).
RESULTS: Among the 325 participants (46% female; mean age 41 ± 14 years; diabetes duration 20 ± 12 years), 57 (18%) achieved all clinical glycaemic targets. These patients had higher concentrations of glutamine, valine, and isoleucine, and lower lactate levels. TIR70-180 correlated negatively with lactate, Glyc B, and Glyc B H/W. Mean glucose was positively associated with IDL-C, IDL-TG, LDL-P, small LDL-P, Glyc A H/W, and lactate, and negatively with glutamine and acetone. Hypoglycaemia metrics were associated with small LDL-P, while glucose variability correlated with alanine [β: - 0.026 (95% CI: - 0.057 to - 0.008); P = 0.013]. In logistic regression analyses adjusted for duration of T1D, glutamine [Exp(B) = 0.993 (95% CI: 0.987-0.999), P = 0.022] and lactate [Exp(B) = 1.004 (95% CI: 1.001-1.007, P = 0.003] were significantly associated with glycaemic control.
CONCLUSIONS: Serum metabolomic profiles reflect CGM-derived glycaemic metrics in T1D, highlighting their potential role as biomarkers for a refined assessment of metabolic control.
METHODS: In this cross-sectional study, 325 adults with T1D were evaluated. CGM metrics were derived from 14-day recordings. Participants were stratified by achievement of clinical glycaemic targets [time in range (TIR70-180) > 70%, coefficient of variation (CV) < 36%, and time below range (TBR < 70) < 5%] into "on-target" and "off-target" groups. Serum metabolomic profiles were quantified using proton nuclear magnetic resonance spectroscopy (1 H-NMR).
RESULTS: Among the 325 participants (46% female; mean age 41 ± 14 years; diabetes duration 20 ± 12 years), 57 (18%) achieved all clinical glycaemic targets. These patients had higher concentrations of glutamine, valine, and isoleucine, and lower lactate levels. TIR70-180 correlated negatively with lactate, Glyc B, and Glyc B H/W. Mean glucose was positively associated with IDL-C, IDL-TG, LDL-P, small LDL-P, Glyc A H/W, and lactate, and negatively with glutamine and acetone. Hypoglycaemia metrics were associated with small LDL-P, while glucose variability correlated with alanine [β: - 0.026 (95% CI: - 0.057 to - 0.008); P = 0.013]. In logistic regression analyses adjusted for duration of T1D, glutamine [Exp(B) = 0.993 (95% CI: 0.987-0.999), P = 0.022] and lactate [Exp(B) = 1.004 (95% CI: 1.001-1.007, P = 0.003] were significantly associated with glycaemic control.
CONCLUSIONS: Serum metabolomic profiles reflect CGM-derived glycaemic metrics in T1D, highlighting their potential role as biomarkers for a refined assessment of metabolic control.