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Glucose fluctuations in subjects with normal glucose tolerance, impaired glucose regulation and newly diagnosed type 2 diabetes mellitus.
Clin Endocrinol (Oxf). 2012 Jun; 76(6):810-5.CE

Abstract

OBJECTIVE

Glycemic variability is poorly studied in the nondiabetic individuals and newly diagnosed patients with type 2 diabetes. The aim of the study is to investigate the characteristics of glucose fluctuations in subjects with normal glucose tolerance (NGT), impaired glucose regulation (IGR) and newly diagnosed, drug-naïve type 2 diabetes mellitus (DM-2).

DESIGN AND PATIENTS

This is a cross-sectional study of three groups including 53 subjects with IGR, 56 DM-2 patients and 53 NGT individuals. Monitoring by a continuous glucose monitoring system (CGMS(®) System Gold(™)) was performed for three consecutive days.

MEASUREMENTS

Mean blood glucose (MBG), standard deviation of MBG (SDBG), largest amplitude of glycemic excursions (LAGE) and mean amplitude of glycemic excursions (MAGE) were calculated to estimate intraday blood glucose variability. Interday variability of glucose was evaluated by absolute means of daily differences (MODD). Postprandial glucose excursion (PPGE) was calculated to assess the influence of meals on glucose fluctuation.

RESULTS

Twenty-two percentage of NGT and 33.9% of IGR individuals experienced blood glucose ≥ 11.1 mmol/l; 49.1% of NGT, 50.9% of IGR and 30.8% of DM-2 participants had hypoglycemic episodes (CGM values <3.9 mmol/l). The IGR and DM-2 groups had greater SDBG (P = 0.010 and P < 0.001), LAGE (P = 0.014 and P < 0.001) and MAGE (P = 0.044 and P < 0.001) compared with the NGT group. Significantly greater MODD and PPGEs were found in the DM-2 groups than in the IGR and NGT groups (P < 0.001). The DM-2 patients had higher 72-MBG and glucose levels overnight than the NGT and IGR subjects (P < 0.001). In the patients with diabetes, MAGE was positively associated with MODD (r = 0.558, P < 0.001) and PPGEs (r = 0.738-0.843, P < 0.001).

CONCLUSIONS

Glucose variability is present to an increasing degree from NGT to IGR and IGR to DM-2. Compared with the NGT individuals, the IGR and DM-2 subjects show more predominant intraday glucose fluctuations. The DM-2 patients demonstrate increased PPGEs, higher glucose levels overnight and greater interday fluctuations.

Authors+Show Affiliations

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Sichuan, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21854404

Citation

Wang, Chun, et al. "Glucose Fluctuations in Subjects With Normal Glucose Tolerance, Impaired Glucose Regulation and Newly Diagnosed Type 2 Diabetes Mellitus." Clinical Endocrinology, vol. 76, no. 6, 2012, pp. 810-5.
Wang C, Lv L, Yang Y, et al. Glucose fluctuations in subjects with normal glucose tolerance, impaired glucose regulation and newly diagnosed type 2 diabetes mellitus. Clin Endocrinol (Oxf). 2012;76(6):810-5.
Wang, C., Lv, L., Yang, Y., Chen, D., Liu, G., Chen, L., Song, Y., He, L., Li, X., Tian, H., Jia, W., & Ran, X. (2012). Glucose fluctuations in subjects with normal glucose tolerance, impaired glucose regulation and newly diagnosed type 2 diabetes mellitus. Clinical Endocrinology, 76(6), 810-5. https://doi.org/10.1111/j.1365-2265.2011.04205.x
Wang C, et al. Glucose Fluctuations in Subjects With Normal Glucose Tolerance, Impaired Glucose Regulation and Newly Diagnosed Type 2 Diabetes Mellitus. Clin Endocrinol (Oxf). 2012;76(6):810-5. PubMed PMID: 21854404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glucose fluctuations in subjects with normal glucose tolerance, impaired glucose regulation and newly diagnosed type 2 diabetes mellitus. AU - Wang,Chun, AU - Lv,Lifang, AU - Yang,Yanzhi, AU - Chen,Dawei, AU - Liu,Guanjian, AU - Chen,Lihong, AU - Song,Yuanxia, AU - He,Liping, AU - Li,Xiujun, AU - Tian,Haoming, AU - Jia,Weiping, AU - Ran,Xingwu, PY - 2011/8/23/entrez PY - 2011/8/23/pubmed PY - 2012/8/18/medline SP - 810 EP - 5 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 76 IS - 6 N2 - OBJECTIVE: Glycemic variability is poorly studied in the nondiabetic individuals and newly diagnosed patients with type 2 diabetes. The aim of the study is to investigate the characteristics of glucose fluctuations in subjects with normal glucose tolerance (NGT), impaired glucose regulation (IGR) and newly diagnosed, drug-naïve type 2 diabetes mellitus (DM-2). DESIGN AND PATIENTS: This is a cross-sectional study of three groups including 53 subjects with IGR, 56 DM-2 patients and 53 NGT individuals. Monitoring by a continuous glucose monitoring system (CGMS(®) System Gold(™)) was performed for three consecutive days. MEASUREMENTS: Mean blood glucose (MBG), standard deviation of MBG (SDBG), largest amplitude of glycemic excursions (LAGE) and mean amplitude of glycemic excursions (MAGE) were calculated to estimate intraday blood glucose variability. Interday variability of glucose was evaluated by absolute means of daily differences (MODD). Postprandial glucose excursion (PPGE) was calculated to assess the influence of meals on glucose fluctuation. RESULTS: Twenty-two percentage of NGT and 33.9% of IGR individuals experienced blood glucose ≥ 11.1 mmol/l; 49.1% of NGT, 50.9% of IGR and 30.8% of DM-2 participants had hypoglycemic episodes (CGM values <3.9 mmol/l). The IGR and DM-2 groups had greater SDBG (P = 0.010 and P < 0.001), LAGE (P = 0.014 and P < 0.001) and MAGE (P = 0.044 and P < 0.001) compared with the NGT group. Significantly greater MODD and PPGEs were found in the DM-2 groups than in the IGR and NGT groups (P < 0.001). The DM-2 patients had higher 72-MBG and glucose levels overnight than the NGT and IGR subjects (P < 0.001). In the patients with diabetes, MAGE was positively associated with MODD (r = 0.558, P < 0.001) and PPGEs (r = 0.738-0.843, P < 0.001). CONCLUSIONS: Glucose variability is present to an increasing degree from NGT to IGR and IGR to DM-2. Compared with the NGT individuals, the IGR and DM-2 subjects show more predominant intraday glucose fluctuations. The DM-2 patients demonstrate increased PPGEs, higher glucose levels overnight and greater interday fluctuations. SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/21854404/Glucose_fluctuations_in_subjects_with_normal_glucose_tolerance_impaired_glucose_regulation_and_newly_diagnosed_type_2_diabetes_mellitus_ L2 - https://doi.org/10.1111/j.1365-2265.2011.04205.x DB - PRIME DP - Unbound Medicine ER -