Endocrinologia, diabetes y nutricion · 2026
Time in range and its association with sudomotor dysfunction in individuals with type 1 diabetes mellitus.
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Quintal-Medina Ismael A, López-Prieto Rossy S, Romero-Torres Karen A, Ulloa Ana Cristina Garcia, Gómez-Pérez Francisco J, Almeda-Valdes Paloma
Аннотация
INTRODUCTION: Time in range (TIR), a novel metric to evaluate glycemic control, is relevant to predict microvascular complications of diabetes. Sudomotor dysfunction is among the earliest findings detectable in diabetic peripheral neuropathy (DPN). This study aimed to evaluate the relationship between TIR obtained from continuous glucose monitoring (CGM) and sudomotor function evaluated by SUDOSCAN in subjects with type 1 diabetes mellitus (T1DM).
MATERIALS AND METHODS: We enrolled 90 individuals with T1DM. All of them underwent SUDOSCAN and 14-day CGM. SUDOSCAN measured feet electrochemical skin conductance (FESC), and sudomotor dysfunction was defined as average FESC<70μS. Logistic regressions were applied to examine the independent association between TIR and glycated hemoglobin (HbA1c) and sudomotor function.
RESULTS: The overall prevalence of sudomotor dysfunction was 65.6%. Patients with sudomotor dysfunction showed a decreased level of TIR (53.3±17.4% vs 64.4±12.7%, P<.05). No significant differences in HbA1c were observed between the groups with and without sudomotor dysfunction (median 8.1% [65mmol/mol] vs 7.6% [60mmol/mol]; P=.094). Correlation analysis showed that the relationship between TIR and FESC was stronger than between HbA1c and FESC. Finally, logistic regression revealed that TIR was inversely associated with the risk of sudomotor dysfunction detected by SUDOSCAN (P<.05).
CONCLUSIONS: TIR is a glycemic control target inversely associated with sudomotor dysfunction assessed by SUDOSCAN in T1DM regardless of HbA1c.
MATERIALS AND METHODS: We enrolled 90 individuals with T1DM. All of them underwent SUDOSCAN and 14-day CGM. SUDOSCAN measured feet electrochemical skin conductance (FESC), and sudomotor dysfunction was defined as average FESC<70μS. Logistic regressions were applied to examine the independent association between TIR and glycated hemoglobin (HbA1c) and sudomotor function.
RESULTS: The overall prevalence of sudomotor dysfunction was 65.6%. Patients with sudomotor dysfunction showed a decreased level of TIR (53.3±17.4% vs 64.4±12.7%, P<.05). No significant differences in HbA1c were observed between the groups with and without sudomotor dysfunction (median 8.1% [65mmol/mol] vs 7.6% [60mmol/mol]; P=.094). Correlation analysis showed that the relationship between TIR and FESC was stronger than between HbA1c and FESC. Finally, logistic regression revealed that TIR was inversely associated with the risk of sudomotor dysfunction detected by SUDOSCAN (P<.05).
CONCLUSIONS: TIR is a glycemic control target inversely associated with sudomotor dysfunction assessed by SUDOSCAN in T1DM regardless of HbA1c.