Alyson Chapman

Bio: Alyson Chapman is an academic researcher from Manchester Academic Health Science Centre. The author has contributed to research in topics: Type 1 diabetes & Blood pressure. The author has an hindex of 1, co-authored 2 publications receiving 2 citations.

Continuous Subcutaneous Insulin Infusion Initiation Is Associated With Blood Pressure Reduction in Adults With Type 1 Diabetes

Abstract: Background:In type 1 diabetes (T1D) continuous subcutaneous insulin infusion (CSII) use has been associated with lower risks for mortality and diabetes-related complications when compared to multip...

Hyperinsulinemia negatively affects the association between insulin resistance and blood pressure.

Abstract: Background and aims Although hyperinsulinemia and insulin resistance (IR) together cause metabolic diseases, the available evidence fails to link hyperinsulinemia with blood pressure (BP) elevation. To further understand the role of hyperinsulinemia in the pathophysiology of hypertension, we conducted this study to investigate the moderating effect of fasting insulin (FINS) on the association between IR and BP. Methods and results The health screening data of 72,076 individuals were analyzed for this moderation analysis. IR was indicated by the homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride-glucose index (TyG), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc). In the adjusted model, three IR indicators were considered independent variables; FINS was used as a moderator, and systolic BP (SBP) and diastolic BP (DBP) were used as dependent variables. The regression coefficient of the interaction term between the three IR indicators and FINS was significantly negative in all moderation models. Simple slope tests and the Johnson–Neymann technique also indicated that FINS negatively moderated the association between IR and BP. Conclusions This moderation analysis showed that FINS negatively mediated the association between IR and BP, suggesting that hyperinsulinemia may buffer, not reinforce, the effect of IR on hypertension.

Real‐world glycaemic outcomes in adult persons with type 1 diabetes using a real‐time continuous glucose monitor compared to an intermittently scanned glucose monitor: A retrospective observational study from the Canadian LMC diabetes registry (REAL‐CGM‐T1D)

Abstract: Real-time continuous glucose monitoring (rtCGM) and intermittently scanned CGM (isCGM) have both been shown to improve glycaemic outcomes in people with T1D. The aim of this study was to compare real-world glycaemic outcomes at 6-12 months in a propensity score matched cohort of CGM naïve adults with T1D who initiated a rtCGM or an isCGM. Among the matched rtCGM and isCGM cohorts (n = 143/cohort), rtCGM users had a significantly greater HbA1c benefit compared to isCGM users (adjusted difference, -3 mmol/mol [95% CI, -5 to -1]; -0.3% [95% CI, -0.5 to -0.1]; p = 0.01). There was a significantly greater lowering of HbA1c for rtCGM compared to isCGM when baseline HbA1c was <69 mmol/mol (8.5%) (adjusted difference, -4 mmol/mol [95% CI, -7 mmol/mol to -2 mmol/mol]; -0.4% [95% CI, -0.6% to -0.2%]; p < 0.001), and in MDI users (adjusted difference, -3 mmol/mol [95% CI, -6 mmol/mol to -0 mmol/mol]; -0.3% [95% CI -0.5% to 0.0%], p = 0.04). The rtCGM cohort had significantly greater time in range (58.3 ± 16.1% vs. 54.5 ± 17.1%, p = 0.03), lower time below range (2.1 ± 2.7% vs. 6.1 ± 5.0%, p < 0.001) and lower glycaemic variability compared to the isCGM cohort. In this real-world analysis of adults with T1D, rtCGM users had a significantly greater reduction in HbA1c at 6-12 months compared to isCGM, and significantly greater time in range, lower time below range and lower glycaemic variability, compared to a matched cohort of isCGM users.