Correlation between glucose fluctuations and carotid intima-media thickness in type 2 diabetes.
OBJECTIVE
To evaluate the relationship between blood glucose fluctuations and carotid atherosclerosis (AS) in type 2 diabetic patients.


METHODS
A case-control study included 36 patients with type 2 diabetes and 10 controls. According to the levels of carotid intima-media thickness (CIMT), 36 diabetic patients were classified into two groups, the diabetes mellitus without atherosclerosis (DM-AS, n=20) and diabetes mellitus with atherosclerosis (DM+AS, n=16). The glucose excursions were assessed by the following parameters obtained from continuous glucose monitoring system for 72h: the mean blood glucose (MBG) and its standard deviation (SD), the area under the ROC curve when the blood glucose was higher than 7.8mmol/L (AUC7.8), the mean amplitude of glycemic excursion (MAGE), the mean of daily differences (MODD), and the largest amplitude of glycemic excursion (LAGE).


RESULTS
The levels of MBG, SD, MAGE, LAGE, and AUC7.8 were gradually increased with the progression of atherosclerosis (P<0.05). The Spearman's correlation analysis showed that the CIMT was correlated to the age (R=0.58, P<0.001), the duration (R=0.50, P<0.001), the MAGE (R=0.34, P=0.021), and the LAGE (R=0.31, P=0.035).


CONCLUSIONS
These results suggest that glucose fluctuations may accelerate atherogenesis in older type 2 diabetic patients who had a longer duration.
Chen
Xiao-min
XM
Department of Endocrinology and Metabolism, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, PR China. chenxiaomin0517@sina.com
Zhang
Yan
Y
Shen
Xing-ping
XP
Huang
Qun
Q
Ma
Hong
H
Huang
Yang-Ling
YL
Zhang
Wen-Qiang
WQ
Wu
Hao-Jie
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D001786:Blood Glucose / Q000032:analysis*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000473:pathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D012307:Risk Factors; D012720:Severity of Illness Index; D013223:Statistics as Topic; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
D001786:Blood Glucose