Abstract

Background and aim: We hypothesised that the detrimental effect of high glucose
variability (GV) in people with type 1 diabetes is mainly evident in those with concomitant insulin resistance.
Materials and methods: We conducted secondary analyses on continuous glucose monitoring (CGM) from three randomised controlled trials and assessed the relationship with established vascular markers. Cluster analysis was employed to establish three GV clusters and the relationship with thrombotic biomarkers was investigated according to insulin resistance, assessed as estimated Glucose Disposal Rate (eGDR).
Results: Of 107 patients, 48, 40, and 19 patients were assigned into low, intermediate, and high GV clusters, respectively. Thrombosis biomarkers increased in a stepwise fashion across all three GV clusters; this increase in thrombosis markers was evident in the presence of low but not high eGDR.
Conclusion: Higher GV is associated with increased thrombotic biomarkers in type 1 diabetes but only in those with concomitant insulin resistance.