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Relationship between blood glucose fluctuation and macrovascular endothelial dysfunction in type 2 diabetic patients

X-G Zhang1, Y-Q Zhang, D-K Zhao

  • 1Department of Endocrinology, General Hospital of Beijing Military Area, Beijing, PR China. xiaofenglv7966@163.com.

European Review for Medical and Pharmacological Sciences
|December 24, 2014
PubMed

Insights

Blood glucose fluctuation, measured by continuous glucose monitoring, is linked to macrovascular dysfunction in type 2 diabetes mellitus (T2DM) patients. This heightened glucose variability may contribute to coronary heart disease (CHD) development.

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Syndrome

Background:

  • Type 2 diabetes mellitus (T2DM) is associated with macrovascular complications, including coronary heart disease (CHD).
  • The role of glycemic variability, beyond average glucose levels, in the pathogenesis of macrovascular dysfunction in T2DM remains an area of active investigation.

Purpose of the Study:

  • To investigate the association between blood glucose fluctuation and macrovascular dysfunction in patients with T2DM.
  • To explore the relationship between glycemic variability parameters and markers of inflammation and endothelial function.

Main Methods:

  • A 72-hour continuous glucose monitoring (CGM) was performed in 88 T2DM patients (with or without CHD) and 30 healthy controls.
  • Brachial artery flow-mediated dilation (FMD) was assessed to evaluate endothelial function.
  • Parameters of glucose excursion, including MAGE, LAGE, MPPGE, MODD, and IAUC70, were analyzed along with HbA1c, fasting insulin, and CRP.

Main Results:

  • T2DM patients with CHD exhibited significantly greater blood glucose fluctuation compared to T2DM patients without CHD and healthy controls.
  • Blood glucose fluctuation demonstrated significant correlations with flow-mediated dilation (FMD), C-reactive protein (CRP), and homeostatic model assessment of insulin resistance (HOMA-IR).

Conclusions:

  • Elevated blood glucose fluctuation is a significant factor influencing inflammatory responses in T2DM patients.
  • Increased glycemic variability may play a crucial role in the development and progression of coronary heart disease in individuals with type 2 diabetes mellitus.
Abstract

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