Correlation between glycemic fluctuation and microvascular complication in type 2 diabetic patients with well-controlled glycosylated hemoglobin

Wei Jiajie; Wen Lina; Zhou Yingsheng

doi:10.3760/j.issn.1673-4777.2018.11.021

Abstract：Objective To analyze the correlation between glycemic fluctuation and microvascular complication in type 2 diabetic patients with glycosylated hemoglobin (HbA1c) ＜ 7％.Methods Sixty-six type 2 diabetic patients with HbA1c ＜ 7％ were enrolled from September 2012 to December 2017 in Beijing Anzhen Hospital,Capital Medical University;35 patients had microvascular complication(group A);31 patients without microvascular complication were group B.HbA1c,fasting blood glucose,blood lipid,liver and kidney function indexes were tested.Mean amplitude of glycemic excursions(MAGE),mean standard deviation of blood glucose(SDBG),24 h mean blood glucose(MBG),maximum and minimum blood glucose,the largest amplitude of glycemic excursions (LAGE),M value and average daily risk range(ADRR) were monitored by the continuous glucose monitoring system.Results Fasting blood glucose and HbA1c level showed no significant difference between the group A and group B (P ＞ 0.05).MAGE,SDBG,MBG,maximum blood glucose,LAGE,M value and ADRR in the group B were significantly higher than those in the group A [(4.6 ± 2.1) mmol/L vs (2.9 ± 1.1) mmol/L,(1.7 ± 0.7) mmol/L vs (1.3 ± 0.4) mmol/L,(8.0 ± 1.7) mmol/L vs (7.2 ± 1.1) mmol/L,(12.5 ± 3.2) mmol/L vs (10.2 ± 1.6) mmol/L,(7.8 ±3.3) mmol/L vs (5.6 ± 1.9) mmol/L,3.6(2.0,8.9) vs 2.1 (1.0,3.7),(18 ± 12) vs (9 ±5)] (P ＜ 0.05).Spearman test showed that MAGE was negatively correlated with levels of fasting C-peptide and triglyceride(r =-0.265,-0.280;P ＜ 0.05).Logistic regression indicated that MAGE was a risk factor of microvascular complication(odds ratio =1.917.P ＜ 0.01).Conclusion Blood glucose fluctuation is an independent risk factor of microvascular complication in type 2 diabetic patients with HbA1c ＜ 7％.