Influencing Factors Analysis of the Dynamic Trajectories of Fasting Blood Glucose-Insulin Resistance in Patients With Type 2 Diabetes Mellitus
10.11714/jsysu.med.YX20250149
- VernacularTitle:2型糖尿病患者空腹血糖-胰岛素抵抗动态轨迹的影响因素分析
- Author:
Xinyuan CUI
1
;
Bojin XU
1
;
Haiping ZHOU
1
;
Juan DU
1
;
Xiaoxu GE
1
;
Yubin TANG
1
;
Shan HUANG
1
;
Wenfang PENG
1
Author Information
1. Department of Endocrinology， Tongren Hospital， Shanghai Jiao Tong University School of Medicine， Shanghai 200336， China
- Publication Type:Journal Article
- Keywords:
type 2 diabetes mellitus;
fasting blood glucose;
insulin resistance;
trajectory analysis;
risk factors
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(1):162-171
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the long-term dynamic trajectories of fasting blood glucose （FBG） and insulin resistance （IR） in patients with type 2 diabetes mellitus （T2DM） and their influencing factors. MethodsThis retrospective cohort study included 1 896 T2DM patients registered at Tongren Hospital from May 2020 to May 2025. Based on longitudinal follow-up data of FBG and fasting insulin， joint latent class mixed models （JLMM） were applied to identify FBG-IR trajectories. Univariate and multinomial logistic regression was used to examine demographic characteristics， lifestyle， and clinical determinants of trajectory type. ResultsFour distinct FBG-IR trajectories were identified： stable FBG-IR （9.76%）， rising FBG-stable IR （5.01%）， stable FBG-elevated IR （75.90%）， and elevated FBG-IR （9.34%）. Compared with the stable FBG-IR group， age ≥60 years was protective against the elevated FBG-stable IR trajectory （OR=0.55， 95%CI：0.33-0.92， P=0.023）. Highereducation increased the risk of stable FBG-elevated IR （OR=1.40， 95%CI：1.01-1.94， P=0.046）. Abnormal blood pressure was associated with lower risks of stable FBG-elevated IR （OR=0.66， 95%CI：0.48-0.92， P=0.013） and elevated FBG-IR （OR=0.48， 95%CI：0.31-0.74， P=0.001）. Non-drinkers were less likely to belong to the stable FBG-elevated IR trajectory （OR=0.39， 95%CI：0.16-0.95， P=0.038）. ConclusionsThe evolution trajectory of FBG and IR in T2DM patients shows significant heterogeneity. The majority of patients have a deterioration of IR first. Age， education level， blood pressure， and alcohol consumption are the main influencing factors. Joint assessment of FBG and IR is helpful for early identification of high-risk individuals and guiding individualized intervention.
