Serum value of Fasting C-peptide (FC-P), fasting insulin (FIns), and glycated hemoglobin (HbA1c) after Dynamic Blood Glucose Monitoring-guided Personalized Nutrition and Insulin Pump Therapy for Type II Diabetes Mellitus

Serum value of Fasting C-peptide (FC-P), fasting insulin (FIns), and glycated hemoglobin (HbA1c)

  • Guohong Zhu Department of Endocrinology, Taizhou People's Hospital, Taizhou 225300, Jiangsu Province, China
Keywords: Serum value of Fasting C-peptide (FC-P), fasting insulin (FIns), and glycated hemoglobin (HbA1c) T2DM; continuous glucose monitoring; quality circle control nursing model; individualized nutrition; insulin pump therapy

Abstract


Introduction: type 2 diabetes mellitus (T2DM) is a chronic metabolic disease requiring comprehensive management of multiple risk factors including blood glucose (BG), blood pressure, and lipids. It to investigate the clinical effects of individualized nutrition and insulin pump therapy guided by continuous glucose monitoring (CGM) based on the quality circle control (QCC) nursing model in T2DM patients and its effect on Fasting C-peptide (FC-P), fasting plasma glucose (FPG), 2-hour postprandial glucose (2 hPG), fasting insulin (FIns), and glycated hemoglobin (HbA1c).

Materials and Methods: eighty T2DM patients treated at our hospital from January 2023 to January 2024 were recruited and rolled into a research group (EG) receiving individualized nutrition and insulin pump therapy guided by CGM based on the QCC nursing model, and a regular group (RG) receiving routine care and treatment. Differences of BG control, insulin usage, CGM downtime, and anomaly occurrence rate were compared between groups.

Results: EG showed marked improvements relative to RG in mean fasting C-peptide (FC-P), fasting plasma glucose (FPG), postprandial 2-hour glucose (2 hPG), fasting insulin (FIns), and glycated hemoglobin (HbA1c) levels (P<0.05). It also reduced time to achieve BG targets, lowered glucose variability and insulin dosage, and decreased the incidence of CGM system anomalies (P<0.05). Treatment effectiveness and nursing satisfaction were markedly higher in EG versus RG (P<0.05).

Conclusion: the QCC nursing model effectively enhances BG control, optimizes insulin therapy, improves dietary habits and quality of life, and reduces hypoglycemic events in T2DM patients. This model deserves promotion and application in clinical practice.

References

Chen, X., Shen, H., and Zhang, M., 2024. Analysis of effect of quality control circle management model on the error rate of disposable item distribution and efficiency of medical workers in sterilization supply center. Altern. Ther. Health Med., 30(2): 102-105.
Ekanayake, P. and Edelman, S., 2023. Identifying patients with type 2 diabetes who might benefit from insulin pump therapy: Literature review, clinical opportunities, potential benefits and challenges. Diabetes Obes. Metab., 25 Suppl 2: 3-20. https://doi.org/10.1111/dom.15059
Grady, M., Cameron, H., Bhatiker, A., Holt, E., and Schnell, O., 2022. Real-world evidence of improved glycemic control in people with diabetes using a bluetooth-connected blood glucose meter with a mobile diabetes management app. Diabetes Technol. Ther., 24(10): 770-778. https://doi.org/10.1089/dia.2022.0134
Grunberger, G., Sherr, J., Allende, M., Blevins, T., Bode, B., Handelsman, Y., Hellman, R., Lajara, R., Roberts, V.L., Rodbard, D., Stec, C. and Unger, J., 2021. American association of clinical endocrinology clinical practice guideline: the use of advanced technology in the management of persons with diabetes mellitus. Endocr. Pract., 27(6): 505-537. https://doi.org/10.1016/j.eprac.2021.04.008
Holzer, R., Bloch, W., and Brinkmann, C., 2022. Continuous glucose monitoring in healthy adults-possible applications in health care, wellness, and sports. Sensors (Basel), 22(5): 2030. https://doi.org/10.3390/s22052030
Jia, W., Weng, J., Zhu, D., Ji, L., Lu, J., Zhou, Z., Zou, D., Guo, L., Ji, Q., Chen, L., Chen, L., Dou, J., Guo, X,. Kuang, H., Li, L., Li, Q., Li, X., Liu, J., Ran, X., Shi, L., Song, G., Xiao, X., Yang, L., Zhao, Z., and Chinese Diabetes Society, 2019. Standards of medical care for type 2 diabetes in China 2019. Diabetes Metab. Res. Rev., 35(6): e3158. https://doi.org/10.1002/dmrr.3158
Kim, K.S., Hong, S., Han, K., and Park, C.Y., 2024. Association of non-alcoholic fatty liver disease with cardiovascular disease and all cause death in patients with type 2 diabetes mellitus: nationwide population based study. BMJ, 384: e076388. https://doi.org/10.1136/bmj-2023-076388
Lanzinger, S., Best, F., Bergmann, T., Laimer, M., Lipovsky, B., Danne, T., Zimny, S., Bramlage, P., Meyhöfer, S., and Holl, R.W., 2022. Dynamics of hemoglobin a1c, body mass index, and rates of severe hypoglycemia in 4434 adults with type 1 or type 2 diabetes after initiation of continuous glucose monitoring. Diabetes Technol. Ther., 24(10): 763-769. https://doi.org/10.1089/dia.2022.0063
Li, H., Chang, G.Y., Jiang, Y.H., Xu, L., Shen, L., Gu, Z.C., Lin, H.W., and Shi, F.H., 2022. System dynamic model simulates the growth trend of diabetes mellitus in chinese population: implications for future urban public health governance. Int. J. Public. Health, 67: 1605064. https://doi.org/10.3389/ijph.2022.1605064
Li, Y. and Liu, H., 2022. Clinical powers of aminoacyl tRNA synthetase complex interacting multifunctional protein 1 (AIMP1) for head-neck squamous cell carcinoma. Cancer Biomark., 34(3): 359-374. https://doi.org/10.3233/CBM-210340
Liu, G., Li, Y., Pan, A., Hu, Y., Chen, S., Qian, F., Rimm, E.B., Manson, J.E., Stampfer, M.J., Giatsidis, G. and Sun, Q., 2023. Adherence to a healthy lifestyle in association with microvascular complications among adults with type 2 diabetes. JAMA Netw. Open., 6(1): e2252239. https://doi.org/10.1001/jamanetworkopen.2022.52239
Lui, D.T.W., Chung, M.S.H., Lau, E.H.Y., Lau, K.T.K., Au, I.C.H., Lee, C.H., Woo, Y.C., Wong, C.K.H., and Cowling, B.J., 2023. Analysis of all-cause hospitalization and death among nonhospitalized patients with type 2 diabetes and SARS-CoV-2 infection treated with molnupiravir or nirmatrelvir-ritonavir during the omicron wave in Hong Kong. JAMA Netw. Open, 6(5): e2314393. https://doi.org/10.1001/jamanetworkopen.2023.14393
Marinović, S., Cigrovski Berković, M., Zjačić-Rotkvić, V. and Kapitanović, S., 2022. Analysis of polymorphisms in EGF, EGFR and HER2 genes in pancreatic neuroendocrine tumors (PNETs). Cancer Genet., 266-267: 44-50. https://doi.org/10.1016/j.cancergen.2022.06.005
Ou, L., Liu, H.R., Shi, X.Y., Peng, C., Zou, Y.J., Jia, J.W., Li, H., Zhu, Z.X., Wang, Y.H., Su, B.M., Lai, Y.Q., Chen, M.Y., Zhu, W.X., Feng, Z., Zhang, G.M., and Yao, M.C., 2024. Terminalia chebula Retz. aqueous extract inhibits the Helicobacter pylori-induced inflammatory response by regulating the inflammasome signaling and ER-stress pathway. J. Ethnopharmacol., 320: 117428. https://doi.org/10.1016/j.jep.2023.117428
Pi, L., Zheng, Y., Shi, X., Wang, Z. and Zhou, Z., 2023. Using point-of-care HbA1c to facilitate the identification of diabetes and abnormal glucose regulation in primary healthcare settings. Front. Public. Health, 11: 1078361. https://doi.org/10.1001/10.3389/fpubh.2023.1078361
Saha, T., Del Caño, R., Mahato, K., De la Paz, E., Chen, C., Ding, S., Yin, L., and Wang, J., 2023. Wearable electrochemical glucose sensors in diabetes management: a comprehensive review. Chem. Rev., 123(12): 7854-7889. https://doi.org/10.1021/acs.chemrev.3c00078
Sasaki, R., Taura, N., Nakao, Y., Fukushima, M., Haraguchi, M., Miuma, S., Miyaaki, H., and Nakao, K., 2023. Hypoglycemia measured by flash glucose monitoring system predicts liver-related events in chronic liver disease patients. Sci. Rep., 13(1): 13791. https://doi.org/10.1038/s41598-023-40910-2
Schütz-Fuhrmann, I., Rami-Merhar, B., Fröhlich-Reiterer, E., Hofer, S.E., Tauschmann, M., Mader, J.K., Resl, M., Kautzky-Willer, A., Winhofer-Stöckl, Y., Laimer, M., Zlamal-Fortunat, S. and Weitgasser, R., 2023. Diabetestechnologie (Update 2023) [Insulin pump therapy and continuous glucose monitoring]. Wien Klin. Wochenschr., 135(Suppl 1): 53-61. https://doi.org/10.1007/s00508-023-02165-9
Su, B., Wang, Y., Dong, Y., Hu, G., Xu, Y., Peng, X., Wang, Q. and Zheng, X., 2022. Trends in diabetes mortality in urban and rural china, 1987-2019: a joinpoint regression analysis. Front. Endocrinol. (Lausanne), 12: 777654. https://doi.org/10.3389/fendo.2021.777654
Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B.B., Stein, C., Basit, A., Chan, J.C.N., Mbanya, J.C., Pavkov, M.E., Ramachandaran, A., Wild, S.H., James, S., Herman, W.H., Zhang, P., Bommer, C., Kuo, S., Boyko, E.J. and Magliano, D.J., 2022. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res. Clin. Pract., 183: 109119. https://doi.org/10.1016/j.diabres.2021.109119
Thomas, F., Signal, M., and Chase, J.G., 2015. Using continuous glucose monitoring data and detrended fluctuation analysis to determine patient condition: a review. J. Diabetes Sci. Technol., 9(6): 1327-35. https://doi.org/10.1177/1932296815592410
Wang, Y., Lai, Y., Du, L., and Shen, W., 2023. Impact of quality control circle on patient outcomes after hepatocellular carcinoma intervention: a meta-analysis. Expert Rev. Anticancer Ther., 23(8): 875-882. https://doi.org/10.1080/14737140.2023.2219899
Ye, H., Feng, X., Hu, X., Zheng, S., and Zheng, L., 2023. The application effect of using quality control circle management to improve the quality of nursing in operating rooms. Panminerva Med., https://doi.org/10.23736/S0031-0808.23.04967-4
Zelada, H., Perez-Guzman, M.C., Chernavvsky, D.R. and Galindo, R.J., 2023. Continuous glucose monitoring for inpatient diabetes management: an update on current evidence and practice. Endocr. Connect. 12(10): e230180. https://doi.org/10.1530/EC-23-0180
Zhang, X., Yang, X.L., Liu, S., Ye, Y.S., Yang, Q.T. and Xia, L.N., 2024. Prevalence of hypertension among type 2 diabetes mellitus patients in China: a systematic review and meta-analysis. Int. Health., 16(2): 144-151. https://doi.org/10.1093/inthealth/ihad047
Zhao, H., Hu, M., Cao, Y., Wu, X., and Zhu, F., 2024. Study on the application of quality control circle activity in postoperative nursing of elderly dental implants. Medicine (Baltimore), 103(2): e36894. https://doi.org/10.1097/MD.0000000000036894
Zhu, Y.T., Jiang, Y.X., Pei, L., Zhu, W.C., and Jin, X.G., 2024. Application of quality control circle in the management of early ambulation after cesarean section: An observational study. Medicine (Baltimore), 103(14): e37633. https://doi.org/10.1097/MD.0000000000037633
Published
2025/04/08
Section
Original paper