Volume 22 Issue 9
Sep.  2024
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(9): 1463-1466
ZHU Chenxi, LI Liyan, ZHAO Xudong, HAO Jingbo, LI Lei. Impact of fluctuating and persistent hyperglycemia on vascular complications in patients with type 2 diabetes mellitus[J]. Chinese Journal of General Practice, 2024, 22(9): 1463-1466. doi: 10.16766/j.cnki.issn.1674-4152.003659
Citation: ZHU Chenxi, LI Liyan, ZHAO Xudong, HAO Jingbo, LI Lei. Impact of fluctuating and persistent hyperglycemia on vascular complications in patients with type 2 diabetes mellitus[J]. Chinese Journal of General Practice, 2024, 22(9): 1463-1466. doi: 10.16766/j.cnki.issn.1674-4152.003659
shu

Impact of fluctuating and persistent hyperglycemia on vascular complications in patients with type 2 diabetes mellitus

doi: 10.16766/j.cnki.issn.1674-4152.003659
  • 1.

    Department of General Practice, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China

Funds:

 LK2021015

  • Received Date: 2024-01-11
    Abstract
  •   Objective  To observe the effects of fluctuating hyperglycemia and persistent hyperglycemia on macrovascular and microvascular complications in patients with type 2 diabetes and explore the possible mechanisms.  Methods  A total of 112 patients with newly diagnosed type 2 diabetes mellitus who were hospitalized in the Affiliated Hospital of Xuzhou Medical University from November 2022 to May 2023 were selected and divided into two groups, 52 patients in the persistent hyperglycemia group and 60 patients in the fluctuating hyperglycemia group according to the mean amplitude of glycemic excursions (MAGE). Macrovascular and microvascular complications were assessed.  Results  The fluctuating hyperglycemia group had higher 2 h blood glucose, 2 h insulin, carotid intima-media thickness (IMT) than the sustained hyperglycemia group (P < 0.05), while high-sensitivity C-reactive protein (hs-CRP), urinary albumin urine creatinine (UACR), brachial endothelium-dependent diastolic function (EDD), and ankle brachial index (ABI) were significantly lower (P < 0.05). Rates of coronary heart disease [30.0% (18 cases) vs. 13.5% (7 cases), χ2=4.394, P=0.036] and rates of cerebral infarction [26.7% (16 cases) vs. 11.5% (6 cases), χ2=4.039, P=0.044] increased, peripheral arteriosclerosis worsened, and diabetic nephropathy [10.0% (6 cases) vs. 25.0% (13 cases), χ2=4.450, P=0.035] and diabetic retinopathy [8.3% (5 cases) vs. 23.1% (12 cases), χ2=4.703, P=0.030] decreased. Multivariate logistic regression analysis showed that the influencing factors of macrovascular complications were 2 h blood glucose, 2 h insulin, MAGE>3.9 mmol/L, and brachial EDD (P < 0.05). The contributing factors for microvascular complications were fasting glucose, glycated hemoglobin, MAGE≤3.9 mmol/L, and hs-CRP (P < 0.05).  Conclusion  Fluctuating hyperglycemia has a greater influence on macrovascular complications in patients with type 2 diabetes, possibly due to impaired endothelial function, whereas sustained hyperglycemia has a stronger impact on microvascular complications, which could be linked to inflammatory responses.

     

    • FullText(HTML)
  • loading
    • References(21)
  • [1]
    林婧格, 白洁. 血糖变异性对糖尿病慢性并发症影响及机制的研究进展[J]. 中国糖尿病杂志, 2023, 31(7): 547-550.

    LIN J G, BAI J. Research progress on the effect and mechanism of glucose variability on chronic complications of diabetes mellitus[J]. Chinese Journal of Diabetes, 2023, 31(7): 547-550.
    [2]
    MARTINEZ M, SANTAMARINA J, PAVESI A, et al. Glycemic variability and cardiovascular disease in patients with type 2 diabetes[J]. BMJ Open Diabetes Res Care, 2021, 9(1): e002032. DOI: 10.1136/bmjdrc-2020-002032.
    [3]
    中华医学会糖尿病学分会. 中国持续葡萄糖监测临床应用指南2017版[J]. 中华糖尿病杂志, 2017, 9(11): 667-675.

    Chinese Diabetes Society. Chinese clinical guideline for continuous glucose monitoring (2017)[J]. Chinese Journal of Diabetes, 2017, 9(11): 667-675.
    [4]
    方福生, 王宁, 刘星宇, 等. 北京地区老年男性2型糖尿病患者血糖波动与随访期糖化血红蛋白的相关性分析[J]. 中华内科杂志, 2022, 61(11): 1234-1238. doi: 10.3760/cma.j.cn112138-20220124-00076

    FANG F S, WANG N, LIU X Y, et al. Correlation between glycemic variability and glycosylated hemoglobin level during follow-up in elderly male patients with type 2 diabetes in Beijin[J]. Chinese Journal of Internal Medicine, 2022, 61(11): 1234-1238. doi: 10.3760/cma.j.cn112138-20220124-00076
    [5]
    CELERMAJER D S, SORENSEN K E, GOOCH V M, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis[J]. Lancet, 1992, 340(8828): 1111-1115. doi: 10.1016/0140-6736(92)93147-F
    [6]
    陈中国, 朱晓丽, 万宇婷, 等. 颈动脉内膜中层厚度与冠心病的相关性分析[J]. 中华介入放射学电子杂志, 2019, 7(1): 31-34.

    CHEN Z G, ZHU X L, WAN Y T, et al. The relationship between carotid intima-media thickness and crononary heart disease[J]. Chinese Journal of Interventional, 2019, 7(1): 31-34.
    [7]
    ALVES-CABRATOSA L, COMAS-CUFÍ M, PONJOAN A, et al. Levels of ankle-brachial index and the risk of diabetes mellitus complications[J]. BMJ Open Diabetes Res Care, 2020, 8(1): e000977. DOI: 10.1136/bmjdrc-2019-000977.
    [8]
    丁庭庭, 钟兴, 杜益君, 等. 2型糖尿病患者葡萄糖范围内时间和平均血糖波动幅度与糖尿病视网膜病变相关性的研究[J]. 中国糖尿病杂志, 2021, 29(6): 443-447.

    DING T T, ZHONG X, DU Y J, et al. Correlation of time in range and mean amplitude of glycemic excursions with diabetic retinopathy in type 2 diabetes mellitus[J]. Chinese Journal of Diabetes, 2021, 29(6): 443-447.
    [9]
    姚星辰, 翟亚玲, 高静歌, 等. 微小病变性肾病合并2型糖尿病患者的临床病理特点及预后分析[J]. 中国全科医学, 2021, 24(2): 183-189.

    YAO X C, ZHAI Y L, GAO J G, et al. Clinicopathological characteristics and prognosis of minimal change nephropathy with type 2 diabetes mellitus[J]. Chinese General Practice, 2021, 24(2): 183-189.
    [10]
    王继政, 刘尚全, 江旭, 等. 血糖波动对糖尿病患者大血管病变的影响与机制[J]. 医学综述, 2019, 25(22): 4493-4497.

    WANG J Z, LIU S Q, JIANG X, et al. Influence and mechanism of glucose fluctuation on diabebetic macrovascular disease[J]. Medical Recapitulate, 2019, 25(22): 4493-4497.
    [11]
    CIECHANOWSKA A, GORA I M, SABALINSKA S, et al. The effect of high and variable glucose on the viability of endothelial cells co-cultured with smooth muscle cells[J]. Int J Mol Sci, 2022, 23(12): 6704. DOI: 10.3390/ijms23126704.
    [12]
    LEE J E, HAN K, YOO J, et al. Association of metabolic parameter variability with esophageal cancer risk: a nationwide population-based study[J]. Pers Med, 2022, 12(3): 375.
    [13]
    LI Z, HUI J, LI S, et al. Trimethylamine N-oxide predicts stroke severity in diabetic patients with acute ischaemic stroke and is related to glycemic variability[J]. Eur J Neurol, 2023, 30(11): 3478-3486.
    [14]
    张丹阳, 张东铭, 王莉梅, 等. 葡萄糖在目标范围内时间与2型糖尿病患者肿瘤标志物的相关性[J]. 中国临床研究, 2023, 36(5): 665-669, 674.

    ZHANG D Y, ZHANG D M, WANG L M, et al. Correlation between glucose time-in-range and tumor markers in type 2 diabetes mellitus patients[J]. Chinese Journal of Clinical Research, 2023, 36(5): 665-669, 674.
    [15]
    BENALIA M, ZELLER M, MOUHAT B, et al. Glycaemic variability is associated with severity of coronary artery disease in patients with poorly controlled type 2 diabetes and acute myocardial infarction[J]. Diabetes Metab, 2019, 45(5): 446-452.
    [16]
    李家秀, 郑天鹏. 糖尿病合并认知功能障碍的研究进展[J]. 现代医药卫生, 2023, 39(5): 842-846, 852.

    LI J X, ZHENG T P. Research progress in diabetes mellitus complicated with cognitive dysfunction[J]. Journal of Modern Medicine & Health, 2023, 39(5): 842-846, 852.
    [17]
    ZHANG C, TANG M, LU X, et al. Relationship of ankle-brachial index, vibration perception threshold, and current perception threshold to glycemic variability in type 2 diabetes[J]. Medicine (Baltimore), 2020, 99: e19374. DOI: 10.1097/MD.0000000000019374.
    [18]
    WAKASUGI S, MITA T, KATAKAMI N, et al. Associations between continuous glucose monitoring - derived metrics and diabetic retinopathy and albuminuria in patients with type 2 diabetes[J]. BMJ Open Diabetes Res Care, 2021, 9(1): e001923. DOI: 10.1136/bmjdrc-2020-001923.
    [19]
    胡晓蓉, 李修英, 许娟, 等. 赋能授权教育模式在糖尿病血糖控制不佳患者中的应用[J]. 中华全科医学, 2021, 19(8): 1339-1342. doi: 10.16766/j.cnki.issn.1674-4152.002055

    HU X R, LI X Y, XU J, et al. Effect of empowerment education model on patients with poor blood glucose control in diabetes mellitus[J]. Chinese Journal of General Practice, 2021, 19(8): 1339-1342. doi: 10.16766/j.cnki.issn.1674-4152.002055
    [20]
    王娴, 潘研, 巴明玉, 等. 2型糖尿病患者膳食因素与平均血糖波动幅度的关联性研究[J]. 中华全科医学, 2022, 20(10): 1691-1694, 1796. doi: 10.16766/j.cnki.issn.1674-4152.002681

    WANG X, PAN Y, BA M Y, et al. Study on the relationship between dietary factors and mean amplitude of glycemic excursions in patients with diabetes mellitus type 2[J]. Chinese Journal of General Practice, 2022, 20(10): 1691-1694, 1796. doi: 10.16766/j.cnki.issn.1674-4152.002681
    [21]
    KANG J, FARDMAN B M, RATAMESS N A, et al. Efficacy of postprandial exercise in mitigating glycemic responses in overweight individuals and individuals with obesity and type 2 diabetes-a systematic review and meta-analysis[J]. Nutrients, 2023, 15(20): 4489. DOI: 10.3390/nu15204489.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (49) PDF downloads(5) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return