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Glucose Impacts Coronary Artery Disease (CAD) in Type 2 Diabetes

Glucose fluctuation has an impact on carotid artery intima-media thickness in T2DM…. 

About 60-80% of T2DM patients die from vascular disease which affects the aorta, coronary artery, cerebral artery, renal artery, and peripheral artery. Blood vessel endothelium are damaged more when there are blood glucose fluctuations compared to chronic hyperglycemia. Stroke events, myocardial infarction, angina pectoris, and sudden death are at least twofold higher in patients with type 2 diabetes than nondiabetics. 

This study included 188 patients divided into three groups: normal group, T2DM without cardiovascular complications, and T2DM with cardiovascular complications. Inclusion criteria were 50 to 69 years old, T2DM, glucose <16.7 mmol/L, without diabetic ketosis, and cardiovascular risk equal or higher than 10%. Coronary artery angiography was performed to determine patients with or without cardiovascular complications. SYNTAX scores were collected for groups with complications and are related to systolic blood pressure, CRP, MAGE, and HbA1c.

Results showed T2DM patients had higher average blood glucose and greater blood glucose fluctuations compared to the normal group. Patients with a larger fluctuation could have a higher risk for CAD. Researchers found a positive correlation between blood glucose fluctuation and carotid artery intima-thickness in T2DM.

Practice Pearls:

  • Glucose fluctuation has an influence on the development of CAD
  • T2DM patients with CAD have a larger glucose fluctuation than normal patients.
  • Blood vessel endothelium can be damaged by glucose fluctuations.

Journal of Diabetes Research July 2013.