Research On The Relationship Between Glucose Fluctuations And Oxidative Stress In Newly Diagnosed Type2Diabetes Mellitus

Objective: For newly diagnosed type2diabetes (T2DM) patients receivedcontinuous subcutaneous insulin infusion (CSII) combined real-time continuousglucose monitoring system (RT-CGMS) or self-monitoring of blood glucose (SMBG),observation before treatment and after3days of blood glucose, islet function andinflammation, explore the relationship between oxidative stress and blood glucosefluctuations.Subjects and Methods: We received50cases of newly diagnosed type2diabetespatients, duration less than1years, ages20-75years old, were randomly divided intoCSII combined RT-CGMS group or CSII joint SMBG group. Two group patients werereceived CSII intensive treatment for three days. Then we compared within the groupand between groups before treatment with treatment after3days of fasting bloodglucose (FBG),2hours postprandial blood glucose (2hPBG), mean amplitude ofglycemic excursion (MAGE), fasting C-peptide (FCP), high-sensitivity C-reactiveprotein (hs-CRP) and8-iso-prostaglandin2a (8-iso-PGF2a). We observed whetherhs-CRP and8-iso-PGF2a are different under different levels of blood glucosefluctuations in RT-CGMS group patients, as well as under different levels of oxidativestress if there had differences in hs-CRP and MAGE. We try to analyze which factorsrelated to MAGE and8-iso-PGF2a. We determined hs-CRP by immune nephelometry,8-iso-PGF2a by enzyme-linked immunosorbent assay. We apply easyGV software to calculate MAGE in RT-CGMS group patients.Result:1. RT-CGMS group and the SMBG group were received three days of intensivetreatment. We compared before with the forth day of treatment within group, bothgroups FBG,2hPBG were significantly decreased (P <0.001), FCP groups weresignificantly higher (P <0.05), hs-CRP and8-iso-PGF2a had no differences (P>0.05).2. Compared RT-CGMS group with the SMBG group, we found that FBG,2hPBG,FCP, hs-CRP and8-iso-PGF2a in two groups had no differences (P>0.05) beforeand after treatment.3. Compared high fluctuations blood glucose group with low fluctuations group,we found that FCP in high fluctuations group was significantly lower than the lowfluctuations group (P <0.05), while there was no differences in age, disease duration,WC, BMI, FPG, HbA1c, SBP, DBP, TG, TC, HDL-C, LDL-C, hs-CRP and8-iso-PGF2a (P>0.05).4. Compared strong oxidative stress oxidative stress group with the weak, wefound that WC in strong oxidative stress group was significantly higher than the weakoxidative stress group (P <0.05). There was no difference in age, duration, BMI, FPG,HbA1c, SBP, DBP, TG, TC, HDL-C, LDL-C, hs-CRP and MAGE (P>0.05).5. Pearson correlation analysis showed that MAGE was negatively correlated withFCP (r=-0.484, P=0.009), but there was no correlation with age, duration, WC, BMI,SBP, DBP, TG, TC, HDL-C, LDL-C, FPG, HbA1c, hs-CRP and8-iso-PGF2a (P>0.05).6. Pearson correlation analysis showed that8-is-PGF2a was positively correlatedwith WC (r=0.522, P=0.004), BMI (r=0.387, P=0.042), but there was nocorrelation with age, duration, SBP, DBP, TG, TC, HDL-C, LDL-C, FPG, HbA1c, FCP,hs-CRP and MAGE (P>0.05).Conclusion:1. The more severe islet dysfunction, the greater the blood sugar fluctuations.Theshort-term intensive therapy significantly improved glycemic control and protected islet function by CSII combined RT-CGMS in newly diagnosed T2DM patients.2. Glucose variability was not associated with oxidative stress in the firstlydiagnosed T2DM patient who applied continuous subcutaneous insulin infusiontherapy.3. Obese or overweight patients enhanced oxidative stress reaction.