“Intra-day” and “Day-to-Day” Glucose Variability Both Increase Oxidative Stress Determined by d-ROMs in Type 2 Diabetes: A Cross-Sectional Study.
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Author Block: MAKOTO OHARA, TOMOYASU FUKUI, MOTOSHI OUCHI, KENTARO WATANABE, TATSUYA SUZUKI, TAKESHI YAMAMOTO, TOSHIYUKI HAYASHI, KENZO OBA, TSUTOMU HIRANO, Tokyo, Japan, Tochigi, Japan, Yamagata, Japan, Ibaraki City, Japan
Aims: Previous clinical studies have found associations between oxidative stress and intra-day glucose variability, but none have reported data linking oxidative stress with glucose variability from day to day. We decided to examine how oxidative stress correlates with both intra-day and day-to-day glucose variability in type 2 diabetes. Methods: The study was designed as a cross-sectional analysis of 68 patients with type 2 diabetes (studied 2012-2015) who underwent 72 hours of continuous glucose monitoring (CGM).
The glucose variability, mean glucose level (MGL), mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD), and total area under the curve of postprandial plasma glucose (AUCPP) were measured on days 2 and 3. Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) were measured before breakfast on day 1. As a marker of oxidative stress, the plasma total oxidant capacity against N, N-diethylparaphenylendiamine was measured by the d-ROMs test on day 1.
Results: The 68 participants had a mean age of 63.2±12.6 years, with a mean disease duration of 12.9±10.4 years and HbA1c of 8.14±1.64%. MGL, HbA1c, MAGE, MODD and AUCPP exhibited significant correlations with d-ROMs, but not with FPG, in univariate analysis. MGL, HbA1c, MAGE, MODD and AUCPP remained significantly related to d-ROMs after adjustment for clinical factors (sex, age, duration of diabetes, smoking habit, insulin use, statin use, angiotensin II receptor blocker use, BMI, LDL-C, HDL-C, TG, eGFR, Systolic Blood Pressure), whereas FPG did not. In multivariate regression analyses, MAGE and MODD were correlated with d-ROMs after adjustment for markers of diabetic control. MAGE was also significantly correlated with MODD.
Conclusions: The present study is the first to demonstrate that oxidative stress is associated with both intra-day and day-to-day glucose variability in patients with type 2 diabetes.
Authors: MAKOTO OHARA, TOMOYASU FUKUI, MOTOSHI OUCHI, KENTARO WATANABE, TATSUYA SUZUKI, TAKESHI YAMAMOTO, TOSHIYUKI HAYASHI, KENZO OBA, TSUTOMU HIRANO, Tokyo, Japan, Tochigi, Japan, Yamagata, Japan, Ibaraki City, Japan