Wen Xu1, Yanhua Zhu1, Xubin Yang1, Hongrong Deng1, Jinhua Yan1, Shaoda Lin2, Huazhang Yang3, Hong Chen4, Jianping Weng5. 1. 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. 2. Department of Endocrinology and Metabolism, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China. 3. Department of Endocrinology and Metabolism, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China. 4. Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. 5. 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.
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.
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 diabeticpatients. METHODS: Ewing tests were performed in 90 newly diagnosed type 2 diabeticpatients and 37 participants with normal glucose tolerance as control from May 1, 2009, through September 30, 2010. According to the scores from Ewing tests, diabeticpatients 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: Giada Acciaroli; Giovanni Sparacino; Liisa Hakaste; Andrea Facchinetti; Giorgio Maria Di Nunzio; Alessandro Palombit; Tiinamaija Tuomi; Rafael Gabriel; Jaime Aranda; Saturio Vega; Claudio Cobelli Journal: J Diabetes Sci Technol Date: 2017-06-01
Authors: Raymond Noordam; Neline C Huurman; Carolien A Wijsman; Abimbola A Akintola; Steffy W M Jansen; Stephanie Stassen; Marian Beekman; Ondine van de Rest; P Eline Slagboom; Simon P Mooijaart; Diana van Heemst Journal: Front Endocrinol (Lausanne) Date: 2018-05-14 Impact factor: 5.555