Previous studies have shown that oxidative stress levels can increase during acute or chronic blood glucose fluctuation in body in type 2 diabetes (T2DM) patients. Elevation in oxidative stress level can damage cell and tissue. Therefore, it is essential to assess the relationship between coronary artery complications and fluctuation in glucose level.
This trial aimed to evaluate the effect of chronic fluctuation in glucose in normal and T2DM patients regarding cardiovascular complications.
Participants were assigned to 3 groups: T2DM patients with cardiovascular complication (group C, n=92), T2DM patients without cardiovascular complication (group B, n=56) and healthy control group (group A, n=40).
Blood glucose fluctuation was recorded at 8 time sessions, which were 0:00–3:00, 3:00–6:00, 6:00–8:00, 8:00–11:00, 11:00–13:00, 13:00–17:00, 17:00–19:00, and 19:00–24:00. Continuous glucose monitoring system (CGMS) for 72 hours, indexes of mean blood glucose (MBG), glucose standard deviation (SD), the largest amplitude of glycemic excursions (LAGE), the average amplitude of glycemic excursions (MAGE), the number of effective blood glucose excursions (NEGE), and postprandial glucose excursions of 3 dinners, CPR, HbA1 were recorded. Syntax score, an angiogrpahic scoring system was used for comprehensive evaluation of coronary lesion in group C.
The results showed significant different in glycemic excursions among three groups. Higher SYNTAX scores were associated with SBP, CRP, MAGE, and HbA1c levels and were significantly correlated at 6:00-8:00 and 11:00-13:00 time points in group C. The findings of this study showed that T2DM participants had higher fluctuation in blood glucose compare to normal healthy participants. Moreover, T2DM participants with cardiovascular complication had even higher fluctuation compare with T2DM participants without cardiovascular complication.
In conclusion, the study suggests that glucose fluctuation in blood can be a risk predictor for occurrence and progression of cardiovascular disease in T2DM patients. This can be a beneficial tool in clinical treatment for T2DM patients.
Zhang X, Xu X, Jiao X. et al. The Effects of Glucose Fluctuation on the Severity of Coronary Artery Disease in Type 2 Diabetes Mellitus. J Diabetes Res. 2013;2013:576916