Multimorbidity, glycaemic variability and time in target range in people with type 2 diabetes: a baseline analysis of the GP-OSMOTIC trial

Chiang, J. I., Manski-Nankervis, J.-A., Thuraisingam, S., Jenkins, A., O'Neal, D., Mair, F. S. , Jani, B. D. , Nicholl, B. I. and Furler, J. (2020) Multimorbidity, glycaemic variability and time in target range in people with type 2 diabetes: a baseline analysis of the GP-OSMOTIC trial. Diabetes Research and Clinical Practice, 169, 108451. (doi: 10.1016/j.diabres.2020.108451) (PMID:32949650)

Abstract

Aims: To explore associations between multimorbidity condition counts (total; concordant (diabetes-related); discordant (unrelated to diabetes)) and glycaemia (HbA1c; glycaemic variability (GV); time in range (TIR)) using data from a randomised controlled trial examining effectiveness of continuous glucose monitoring (CGM) in people with type 2 diabetes (T2D). Methods: Cross-sectional study: 279 people with T2D using baseline data from the General Practice Optimising Structured MOnitoring To Improve Clinical outcomes (GP-OSMOTIC) trial from 25 general practices in Australia. Number of long-term conditions (LTCs) in addition to T2D used to quantify total/concordant/discordant multimorbidity counts. GV (measured by coefficient of variation (CV)) and TIR derived from CGM data. Multivariable linear regression models used to examine associations between multimorbidity counts, HbA1c (%), GV and TIR. Results: Mean (SD) age of participants 60.4 (9.9) years; 40.9% female. Multimorbidity was present in 89.2% of participants. Most prevalent comorbid LTCs: hypertension (57.4%), painful conditions (29.8%), coronary heart disease (22.6%) and depression (19.0%). No evidence of associations between multimorbidity counts, HbA1c, GV and TIR. Conclusions: While multimorbidity was common in this T2D cohort, it was not associated with HbA1c, CV or TIR. Future studies should explore factors other than glycaemia that contribute to the increased mortality observed in those with multimorbidity and T2D.

• Item Type: Articles
• Additional Information: The GP-OSMOTIC trial was supported by a Project Grant from the National Health and Medical Research Council (NHMRC) of Australia (ID APP1104241). Additional funding was provided by Sanofi Australia. In-kind support (Flash Libre Pro reader devices, sensors, and software) was provided by Abbott Diabetes Care. JC was supported by a NHMRC postgraduate scholarship (ID APP1168372). AJ was supported by a NHMRC Practitioner Fellowship and was a Sydney Medical School Foundation Fellow. JMN was supported by a Next Generation Clinical Researchers Program – TRIP Fellowship Funded from the Medical Research Future Fund.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jani, Dr Bhautesh and Chiang, Mr Jason and Nicholl, Dr Barbara and Mair, Professor Frances
• Authors: Chiang, J. I., Manski-Nankervis, J.-A., Thuraisingam, S., Jenkins, A., O'Neal, D., Mair, F. S., Jani, B. D., Nicholl, B. I., and Furler, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Diabetes Research and Clinical Practice
• Publisher: Elsevier
• ISSN: 0168-8227
• ISSN (Online): 1872-8227
• Published Online: 17 September 2020
• Copyright Holders: Copyright © 2020 Elsevier B.V.
• First Published: First published Diabetes Research and Clinical Practice 169: 108451
• Publisher Policy: Reproduced in accordance with the publisher copyright policy