title: Glucose fluctuations in association with oxidative stress among children with T1DM: comparison of different phases.
abstract: BACKGROUND
  Previous studies on the association between glucose fluctuations and oxidative stress in diabetes mellitus were all conducted in adults, and most study participants had type 2 diabetes mellitus.
  
  
  OBJECTIVE
  The study objective was to examine the association of glucose fluctuation and oxidative stress in children with type 1 diabetes mellitus (T1DM) across different phases.
  
  
  METHODS
  This was a case-control study.
  
  
  METHODS
  The setting was the Beijing Children's Hospital (2010-2013).
  
  
  METHODS
  Children treated for T1DM were divided into three study groups, including group A (newly diagnosed cases in the acute metabolic disturbance phase), group B (the honeymoon phase), and group C (the long-standing phase). Healthy control children were matched to the T1DM patients by age and sex.
  
  
  METHODS
  There were no interventions.
  
  
  METHODS
  The 24-hour urinary free 8-iso-prostaglandin F2α to creatinine (8-iso-PGF2α/Cr) ratio indicated oxidative stress. Glucose fluctuation parameters (GFPs) included mean blood glucose levels, standard deviation of daily blood glucose levels, mean amplitude of glucose excursions, and incremental area under the curve for postprandial glucose.
  
  
  RESULTS
  In each study group, 8-iso-PGF2α/Cr and all GFPs in children with T1DM were significantly higher than those in normal controls. 8-iso-PGF2α/Cr was significantly correlated with all GFPs in all three T1DM groups. A stronger association with 8-iso-PGF2α/Cr for mean amplitude of glucose excursions than for glycated hemoglobin was observed in both the acute metabolic disturbance and long-standing phases of T1DM.
  
  
  CONCLUSIONS
  Glucose fluctuations were positively associated with oxidative stress in T1DM patients in different phases. Glucose fluctuations may have a stronger effect than sustained chronic hyperglycemia on triggering oxidative stress, but coexisting high levels of blood glucose may be required.
authors.affiliation: Department of Endocrinology, Genetics, and Metabolism (X.M., C.G., B.C., D.W., Y.G., L.W., X.L., M.L., W.L., C.S.), Ministry of Education National Key Discipline of Pediatrics (X.M., C.G., B.C., D.W., Y.G., L.W., X.L., M.L., W.L., C.S.), and Center of Clinical Epidemiology and Evidenced Based Medicine (X.P.), Beijing Children's Hospital, Capital Medical University, Beijing 100045, P.R. China.
authors.forename: Xi
authors.initials: X
authors.lastname: Meng
authors.forename: Chunxiu
authors.initials: C
authors.lastname: Gong
authors.forename: Bingyan
authors.initials: B
authors.lastname: Cao
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Peng
authors.forename: Di
authors.initials: D
authors.lastname: Wu
authors.forename: Yi
authors.initials: Y
authors.lastname: Gu
authors.forename: Liya
authors.initials: L
authors.lastname: Wei
authors.forename: Xuejun
authors.initials: X
authors.lastname: Liang
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.forename: Wenjing
authors.initials: W
authors.lastname: Li
authors.forename: Chang
authors.initials: C
authors.lastname: Su
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D015237:Dinoprost / Q000031:analogs & derivatives / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D018384:Oxidative Stress / Q000502:physiology*; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; C075750:8-epi-prostaglandin F2alpha; D003404:Creatinine; D015237:Dinoprost