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Glucose variability, blood pressure and arterial stiffness in type 1 diabetes

D Gordin1, M Rönnback, C Forsblom

  • 1Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland.

Diabetes Research and Clinical Practice
|March 8, 2008
PubMed

Insights

High mean daily blood glucose, not glucose variability, is linked to arterial stiffness in type 1 diabetes. However, glucose variability impacts blood pressure changes during hyperglycaemia.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Research

Background:

  • Chronic hyperglycemia is a risk factor for both microvascular and macrovascular complications in diabetes.
  • The independent contribution of glucose variability versus total glucose exposure to macrovascular risk remains unclear.

Purpose of the Study:

  • To investigate the influence of daily glucose variability on blood pressure and arterial stiffness in type 1 diabetes patients.
  • To assess these effects at baseline and during a controlled hyperglycemic clamp.

Main Methods:

  • Continuous glucose monitoring over 72 hours in 22 male type 1 diabetes patients without complications.
  • Blood pressure, pulse wave analysis, and pulse wave velocity (PWV) measurements.
  • Assessments performed before and during a 2-hour hyperglycemic clamp.

Main Results:

  • No correlation found between Mean Amplitude of Glycemic Excursions (MAGE) and baseline arterial stiffness.
  • Mean daily glucose correlated with aortic PWV, independent of BMI, HbA1c, and diabetes duration (r=0.48, P<0.01).
  • MAGE independently correlated with the change in aortic diastolic blood pressure during the clamp (r=0.52, P<0.01).

Conclusions:

  • High mean daily glucose, rather than glucose variability, is associated with arterial stiffness in type 1 diabetes.
  • Daily glucose variability is positively linked to changes in central blood pressure during hyperglycemic conditions.
Abstract

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