A Study Of The Glycaremic Excursion Shown By T2DM Patients With Lower Extremity Vascular Diseases

Objective: To discuss the features and control targets of the glucose fluctuation ofType2Diabetes (T2DM) patients with lower extremity vascular diseases.Methods:80T2DM patients were monitored in terms of blood pressure, blood lipidsand HbA1c, with their age, course of disease and body mass index (BMI) recorded. Theeighty T2DM patients then underwent72-hour Continuous Glucose Monitoring (CGM),and the lower extremity vascular disease of each patient was evaluated by clinical orultrasonic score. Statistics were analyzed by the statistical software SPSS17.0.Results:1. The Mean Blood Glucose (MBG) of the40subjects with lower extremity vasculardiseases is9.36±2.52mmol/L. SDBG is2.52±1.10mmol/L, and MAGE,5.84±2.93mmol/L.The incidence of hypoglycemia is45%(18/40).Compared with the control group, significant differences are noted in HDL-C, Cr,MAGE, SDBG, LBG of T2DM patients with lower extremity vascular diseases.2. Taking the clinical score of the degree of lower extremity vascular diseases as thedependent variable, and the Glucose Fluctuation Index as the independent variable, the multiplelinear regression analysis manifests that MAGE, LBG and the course of disease have asignificant impact on the clinical score of lower extremity vascular diseases.3. In mild group, there are14patients, moderate and severe group,18. A comparison ofgeneral clinical index between three groups shows that there are significant differences inage, course of disease, BMI, Diastolic Blood Pressure (DBP) and HDL.The comparison between the normal group and mild group indicates that significantdifferences exist in MAGE, SDBG, but the differences in the Glucose Fluctuation Index(MAGE, SDBG) between the moderate and severe group and the mild group are notsignificant.4. There are significant differences in Glucose Fluctuation Index, MBG, SDBG, MAGE, LAGE, percentage rate of patients with higher MAGE, rate of HBG, time of HBG and timepercentage of HBG between the group whose HbA1c is＞7%and the group whose HbA1cis≤7%(P<0.01); While no significant difference is noted in FGE, rate of LBG, time of LBGand time percentage of LBG.Compared with the group with normal MAGE, the Low Blood Glucose Index (LBGI)(rate of LBG, time of LBG, time percentage of LBG) of patients with higher MAGE showssignificant differences. The correlation between the Glucose Fluctuation Index and theHypoglycemia Index has been analyzed and Pearson correlation coefficient indicates that theGlucose Fluctuation Index (MAGE, MBG, SDBG, LAGE) correlates with the HypoglycemiaIndex (time of LBG, time percentage of LBG)(r=0.293,-0.214,0.272,0.288, P<0.01).When HbA1c is≤7, taking blood glucose≤3.9mmol/L as a standard, the area under thecurve of MAGE and SDBG is0.818and0.850respectively (P<0.01in both cases). Thecontrol target of MAGE is≤3.7mmol/L, and that of SDBG is≤1.73mmol/L.Conclusions:1. T2DM patients with lower extremity vascular diseases have greater glucose fluctuation.The incidence of hypoglycemia is high.2. MAGE, LBG and the course of disease have a significant impact on the lowerextremity vascular diseases.3. The ultrasonic scores can reflect the mild vascular lesions degree. The early controlof HbA1c and MAGE is beneficial to lower extremity vascular.4. Hypoglycemia is not correlated to HbA1c, but is correlated to MAGE.5. The control target of MAGE is≤3.7mmol/L, and that of SDBG is≤1.73mmol/Lfor those T2DM patients with lower extremity vascular diseases whose HbA1c is wellcontrolled.