%0 Journal Article
%T Relationship between fluctuations in glucose levels measured by continuous glucose monitoring and vascular endothelial dysfunction in type 2 diabetes mellitus
%A Keiichi Torimoto
%A Yosuke Okada
%A Hiroko Mori
%A Yoshiya Tanaka
%J Cardiovascular Diabetology
%D 2013
%I BioMed Central
%R 10.1186/1475-2840-12-1
%X Fluctuations in blood glucose levels were measured over 24£¿hours by continuous glucose monitoring (CGM) on admission day 2 in 57 patients with type 2 diabetes mellitus. The reactive hyperemia index (RHI), an index of vascular endothelial function, was measured using peripheral arterial tonometry (EndoPAT) on admission day 3.The natural logarithmic-scaled RHI (L_RHI) correlated with SD (r=£¿0.504; P<0.001), the mean amplitude of glycemic excursions (MAGE) (r=£¿0.571; P<0.001), mean postprandial glucose excursion (MPPGE) (r=£¿0.411; P=0.001) and percentage of time ¡Ý200£¿mg/dl (r=£¿0.292; P=0.028). In 12 patients with hypoglycemia, L_RHI also correlated with the percentage of time at hypoglycemia (r=£¿0.589; P=0.044). L_RHI did not correlate with HbA1c or fasting plasma glucose levels. Furthermore, L_RHI did not correlate with LDL cholesterol, HDL cholesterol, and triglyceride levels or with systolic and diastolic blood pressures. Finally, multivariate analysis identified MAGE as the only significant determinant of L_RHI.Fluctuations in blood glucose levels play a significant role in vascular endothelial dysfunction in type 2 diabetes.UMIN000007581Death due to ischemic heart disease and onset of myocardial infarction are approximately 2 to 6 times greater and the risk of stroke is approximately 2 to 3 times greater in patients with type 2 diabetes than normal population [1-5]. Microvascular complications may be ameliorated and/or inhibited by the control of blood glucose levels through maintenance of hemoglobin A1c (HbA1c) below a critical level. However, the outcome of recent large-scale clinical studies suggested that strict glycemic control using HbA1c alone is not sufficient to reduce the risk of macrovascular complications [6,7]; rather, the total number of deaths remained significantly high after intensive therapy [7]. In this regard, severe hypoglycemia has been reported to be an important cause of increased incidence of sudden cardiovascular death [8].In addition to
%K Atherosclerosis
%K Type 2 diabetes mellitus
%K Endothelium
%K Glucose
%K Continuous glucose monitoring (CGM)
%U http://www.cardiab.com/content/12/1/1