ArticleJournal of diabetes2026
Continuous Glucose Monitoring-Derived Glycemic Phenotypes Reflect Metabolic Heterogeneity Linked to Advanced Cardiovascular-Kidney-Metabolic Syndrome in Older Adults With Type 2 Diabetes.
Hang Su, Jiaying Ni, Jinghao Cai, Jingyi Guo, Yufei Wang, Xiaojing Ma, Jingyi Lu, Jian Zhou, Feng Jiang
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Hang SuDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Jiaying NiDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Jinghao CaiDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Jingyi GuoClinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yufei WangDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Xiaojing MaDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.ORCID https://orcid.org/0000-0001-9607-161X Jingyi LuDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.ORCID https://orcid.org/0000-0003-1105-4189 Jian ZhouDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.ORCID https://orcid.org/0000-0002-1534-2279 Feng JiangDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.ORCID https://orcid.org/0009-0006-0779-1732 Funding
Noncommunicable Chronic Diseases-National Science and Technology Major Project 2024ZD0532000Noncommunicable Chronic Diseases-National Science and Technology Major Project 2024ZD0532001Sanming Project of Medicine in Shenzhen SZSM202311019Shanghai Leading Talent Program of Eastern Talent Plan LJ2024121Shenzhen Medical Research Fund C2406002
6 · The paper itselfAbstract
backgroundTo investigate the metabolic characteristics of continuous glucose monitoring (CGM)-derived glycemic phenotypes and their association with cardiovascular-kidney-metabolic (CKM) syndrome in older adults with Type 2 diabetes.
methodsClinical and biochemical data, including estimated β-cell function and insulin resistance, along with CGM data, were collected from 2491 adults aged ≥ 60 years with Type 2 diabetes. CKM syndrome was staged according to the American Heart Association criteria, with Stages 3-4 defined as advanced CKM syndrome. CGM-derived glycemic phenotypes were constructed using an outcome-guided workflow combining XGBoost feature-importance analysis with correlation analysis and clinical interpretability.
resultsThe prevalence of advanced CKM syndrome was 65.0% in our population. Using an outcome-guided and clinically interpretable workflow, time above range (TAR
conclusionsCGM-derived glycemic phenotypes demonstrated distinct metabolic profiles and differential associations with advanced CKM syndrome, suggesting that CGM data may help inform personalized management strategies for older adults with Type 2 diabetes.
Indexed as
Blood GlucoseCardio-Renal SyndromeDiabetes Mellitus, Type 2Metabolic SyndromeAgedBiomarkersContinuous Glucose MonitoringFemaleHumansMaleMiddle AgedPhenotypeBiomarkersBlood Glucosecardiovascular‐kidney‐metabolic syndromecontinuous glucose monitoringglycemic phenotypeolder adults with diabetes
Identifiers
PMID43009136
PMCPMC13751066
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