Correlation between glucose fluctuations and carotid intima-media thickness in type 2 diabetes

Abstract: Aims: To evaluate the relationship between blood glucose fluctuations and carotid atherosclerosis (AS) in type 2 diabetic patients. Methods: A case-control study included 36 patients with type 2 diabetes and 10 controls. According to the levels of carotid intima-media thickness (CIMT), 36 diabetic patients were classified into two groups, the diabetes mellitus without atherosclerosis (DM−AS, n =20) and diabetes mellitus with atherosclerosis (DM+AS, n =16). The glucose excursions were assessed by the following parameters obtained from continuous glucose monitoring system for 72h: the mean blood glucose (MBG) and its standard deviation (SD), the area under the ROC curve when the blood glucose was higher than 7.8mmol/L (AUC7.8), the mean amplitude of glycemic excursion (MAGE), the mean of daily differences (MODD), and the largest amplitude of glycemic excursion (LAGE). Results: The levels of MBG, SD, MAGE, LAGE, and AUC7.8 were gradually increased with the progression of atherosclerosis (P <0.05). The Spearman''s correlation analysis showed that the CIMT was correlated to the age (R =0.58, P <0.001), the duration (R =0.50, P <0.001), the MAGE (R =0.34, P =0.021), and the LAGE (R =0.31, P =0.035). Conclusion: These results suggest that glucose fluctuations may accelerate atherogenesis in older type 2 diabetic patients who had a longer duration. [Copyright &y& Elsevier]