title: Glycemic variability is an important risk factor for cardiovascular autonomic neuropathy in newly diagnosed type 2 diabetic patients.
abstract: BACKGROUND
  The relationship between glycemic variability, another component of glycemic disorders as well as chronic sustained hyperglycemia, and cardiovascular autonomic neuropathy (CAN) has not been clarified. Our aim is to investigate the association between glycemic variability and CAN in newly diagnosed type 2 diabetic patients.
  
  
  METHODS
  Ewing tests were performed in 90 newly diagnosed type 2 diabetic patients and 37 participants with normal glucose tolerance as control from May 1, 2009, through September 30, 2010. According to the scores from Ewing tests, diabetic patients were divided into two groups: without CAN (CAN-) and with CAN (CAN+). All participants underwent a 48-h to 72-h continuous glucose monitoring (CGM). Coefficient of variability of glycemia (%CV), mean amplitude of glycemic excursions (MAGE) and means of daily differences (MODD) were calculated with the CGM data.
  
  
  RESULTS
  The prevalence of CAN in patients with newly diagnosed type 2 diabetes was 22.2%. An increasing trend of glycemic variability was found from control group, CAN- group to CAN+ group. MAGE in CAN+ group was significantly higher than that in CAN- group (5.27±1.99mmol/L vs. 4.04±1.39mmol/L, P=0.001). In the Logistic regression analysis, a significant relationship was shown between MAGE and CAN [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.01-2.73, P=0.018)]. The area under the receiver-operating characteristic curve for MAGE was superior to those for other dysglycemic indices in detecting CAN.
  
  
  CONCLUSIONS
  Glycemic variability is associated with CAN in patients with newly diagnosed type 2 diabetes. Among the glycemic variability indices, MAGE is a significant indicator for detecting CAN.
authors.affiliation: Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Xubin
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Hongrong
authors.initials: H
authors.lastname: Deng
authors.affiliation: Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Yan
authors.affiliation: Department of Endocrinology and Metabolism, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Shaoda
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Endocrinology and Metabolism, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China.
authors.forename: Huazhang
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, China. Electronic address: wjianp@mail.sysu.edu.cn.
authors.forename: Jianping
authors.initials: J
authors.lastname: Weng
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D003929:Diabetic Neuropathies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Cardiovascular autonomic neuropathy; Glycemic variability; Type 2 diabetes mellitus