A case-control study on gender difference of glycemic variability in elderly patients with type 2 diabetes

FANG Fu-sheng; CHENG Xiao-ling; LI Zhi-bing; LI Jian; TIAN Hui; LI Chun-lin

doi:10.3969/j.issn.1672-8157.2013.04.004

Abstract：Objective:To investigate the gender difference of glycemic variability in elderly patients with type 2 diabetes. Methods:A case-control study was conducted among elderly type 2 diabetic inpatients who received continuous glucose monitoring (CGM). Forty female patients were recruited as case group, and 40 male patients who were matched in 1∶1 with similar race, age (± 3 years) and diabetes duration (± 3 years) were recruited as control group. The mean amplitude of glycaemic excursion (MAGE) and standard deviation of blood glucose (SDBG) were adopted to evaluate glycemic variability. The diagnosis criteria of Chinese Diabetes Society Guideline in 2011 was used as normal reference value of glycemic variability. The data were analyzed by univariate and multivariate unconditional Logistic regression models to discriminate the gender difference of glycemic variability in elderly patients with type 2 diabetes. Results:MAGE [(4.88 ± 1.90)vs.(3.71 ± 1.72)mmol·L-1, P<0.01] and SDBG [(1.97 ± 0.68) vs.(1.52 ± 0.73)mmol·L-1, P<0.01] were both higher in female patients than in male patients. Univariate unconditional Logistic regression analysis showed that gender was associated with selected variables of glycemic variability including MAGE and SDBG. After adjustment for age, BMI, diabetes duration, insulin therapy, total cholesterol and HbA1c, multivariate unconditional Logistic regression analysis demonstrated that gender was a significant influential factor of glycemic variability, with OR (95%CI) of MAGE 3.76 (1.301–10.868, P=0.014) and SDBG 5.86 (1.769–19.415, P=0.004). Conclusion:Gender difference was found in glycemic variablity in elderly patients with type 2 diabetes. The level of glycemic variability was higher in female patients than in male patients.