The Relationship Between Blood Glucose Fluctuations And Vascular Complications In Type2 Diabetic Patients

Objective:To investigate the relation between type 2 diabetic Vascular complications, blood glucose fluctuation characteristics and correlation with insulin resistance.Methods:Study:Select January 2008----March 2011 in the Department of Endocrinology, Affiliated Hospital of Shanxi Medical University hospital glucose monitoring in parallel with type 2 diabetes mellitus (T2DM) patients,83 cases, including 38 males and 43 females, age 17～65 years old. Meet the 1999 WHO diagnostic criteria for diabetes.Groups:(1) based on the measured ankle-brachial index (ABI) values were divided into two groups:ABI<0.9 for the low ABI group; 0.9≤ABI≤1.3 for the normal group; The maximum value of ABI measured by the Study Group is 1.29; (2) According to the urinary albumin creatinine ratio (ACR) were divided into 3 groups:ACR<30μg/min for the NAU group; 30μg/min≤ACR<300μg/min for the MAU group; ACR≥300μg/min as LAU group; theMAU group and LAU group known as the AU; (3) According to the average blood glucose fluctuations (MAGE) were divided into two groups:MAGE>3.4mmol/L forthe higher MAGE group; MAGE≤3.4mmol/L for normal MAGE group.Results:1. In type 2 diabetic patients, LAU group MAGE (5.6±0.67) mmol/L, MAU group MAGE (4.8±0.15) mmol/L was significantly higher than NAU group; low ABI group MAGE (4.95±0.23) mmol/L, significantly higher In the normal ABI group (P<0.01).2. MAGE more than the control group's x+1.96 s (3.4mmol/L) increased as the MAGE diagnostic criteria,83 subjects were elevated in the MAGE group of 42 patients (50.6%), its low ABI, LAU and MAU MAGE was higher than normal incidence of type 2 diabetes group (61.9% vs 29.3%; 35.7% compared with 7.3%; 33.3% compared with 14.6%, both P<0.01).3. MAGE with type 2 diabetes age, duration, and HbAlc was positively correlated with ISI was negatively correlated; stepwise multiple regression analysis, age, disease duration and HbAlc and MAGE level was positively correlated with ISI was negatively correlated; Removal of age and duration of diabetes show, MAGE only with the ISI was negatively correlated and with HbA1c are not related.4. Logistic regression analysis showed that:the level of ABI compared with age, duration and MAGE in type 2 diabetic patients is negative correlation, while the ISI was positively associated with ABI.5. Logistic regression analysis showed that:the ACR group as the dependent variable, age, disease duration, HbAlc, and MAGE in patients with type 2 diabetes was positively correlated with the AU, ISI was negatively correlated with the AU.Conclusions:1. Blood glucose fluctuations in type 2 diabetic patients is one of major risk factor for microvascular disease;2. Insulin resistance is the major factors affecting the level of blood glucose fluctuations, HbAlc represent for the overall level of blood glucose, but does not reflect the characteristics of blood glucose stability...