Glycaemic variability is associated with coronary artery calcium in men with Type 1 diabetes: the Coronary Artery Calcification in Type 1 Diabetes study.
OBJECTIVE
We investigated coronary artery calcium in association with glucose levels and variability measured using continuous glucose monitoring in adults with Type 1 diabetes in the Coronary Artery Calcification in Type 1 Diabetes study.


METHODS
Coronary artery calcium was measured by electron beam tomography. The presence of any coronary artery calcium was analysed with respect to glucose levels [mean(T) (mean glucose), % of values < 3.9 mmol/l, > 10 mmol/l and either < 3.9 or > 10 mmol/l] and glycaemic variability [sd(T) (sd of all glucose values); sd(dm) (sd of the daily mean glucose levels) and sd(hh:mm) (glucose sd for a specified time of day, over all days)] using 3-5 days of continuous glucose monitoring from 75 subjects (45 women, 30 men), age 42 ± 9 years (mean ± sd) and diabetes duration of 29 ± 8 years using logistic regression.


RESULTS
We observed significant associations between coronary artery calcium and mean(T) (OR = 4.4, 95% CI 1.1-18.6), % of values > 10 mmol/l (OR = 5.5, 95% CI 1.3-22.6), % of measures < 3.9 or > 10 mmol/l (OR = 5.7, 95% CI 1.3-24.9), sd(T) (OR = 4.7, 95% CI 1.1-19.7), sd(dm) (OR = 6.0, 95% CI 1.2-30.4) and sd(hh:mm) (OR = 4.0, 95% CI 1.1-15.4), among men, but none of these variables were associated with the presence of coronary artery calcium in women.


CONCLUSIONS
We report the novel finding that subclinical atherosclerosis is associated with glucose levels and variability in men with Type 1 diabetes. The relationship of coronary artery calcium and glucose variability in Type 1 diabetes, and potential gender differences in this association, deserve further study.
Barbara Davis Center for Childhood Diabetes, School of Medicine, University of Colorado Denver, Aurora, CO, USA.
J K
JK
Snell-Bergeon
R
R
Roman
D
D
Rodbard
S
S
Garg
D M
DM
Maahs
I E
IE
Schauer
B C
BC
Bergman
G L
GL
Kinney
M
M
Rewers
D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002118:Calcium / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology / Q000473:pathology*; D003331:Coronary Vessels / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D003925:Diabetic Angiopathies / Q000097:blood / Q000150:complications / Q000473:pathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D012307:Risk Factors; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed
D001786:Blood Glucose; D002118:Calcium; D006442:Glycated Hemoglobin