ArticleJournal of endocrinological investigation2026
Metabolomic signatures of glycemic control in type 1 diabetes: insights from continuous glucose monitoring.
Article in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis 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.
methodsIn 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).
resultsAmong 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.
conclusionsSerum metabolomic profiles reflect CGM-derived glycaemic metrics in T1D, highlighting their potential role as biomarkers for a refined assessment of metabolic control.
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