Acute and chronic fluctuations in blood glucose levels can increase oxidative stress in type 2 diabetes mellitus

• Published in: Acta diabetologica Vol. 49; no. Suppl 1; pp. 171 - 177
• Main Authors: Chang, Chih-Min, Hsieh, Ching-Jung, Huang, Ju-Chun, Huang, I-Chin
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.12.2012; Springer Nature B.V
• Subjects: Adult; Aged; Blood Glucose - analysis; Blood Glucose - metabolism; C-Reactive Protein - analysis; C-Reactive Protein - metabolism; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - metabolism; Female; Glucose; Glycated Hemoglobin A - analysis; Glycated Hemoglobin A - metabolism; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Original Article; Oxidative Stress; Oxidative stress; Mean amplitude of glycemic excursions; Blood glucose fluctuations; 8-iso-prostaglandin F2α
• ISSN: 0940-5429; 1432-5233; 1432-5233
• DOI: 10.1007/s00592-012-0398-x

In order to investigate whether short- or long-term glycemic fluctuations could induce oxidative stress and chronic inflammation, we evaluated the relationships between glycemic variability, oxidative stress markers, and high-sensitivity C-reactive protein (hs-CRP). We enrolled 34 patients with type 2 diabetes. As a measure of short-term glycemic variability, mean amplitude of glycemic excursions (MAGE) was computed from continuous glucose monitoring system data. For determining long-term glycemic variability, we calculated the standard deviation (SD) of hemoglobin A1c (HbA1c) levels measured over a 2-year period. Levels of oxidative stress markers: 8-iso-prostaglandin F2α (8-iso-PGF2α), thiobarbituric acid-reactive substance (TBARS), 8-hydroxydeoxyguanosine (8-OHdG), and hs-CRP were measured. MAGE was significantly correlated with the SD of HbA1c levels ( r  = 0.73, p  < 0.001) but not with HbA1c level. The levels of hs-CRP, TBARS, 8-OHdG, and 8-iso-PGF2α were significantly correlated with MAGE ( r  = 0.54, p  = 0.001; r  = 0.82, p  < 0.001; r  = 0.70, p  < 0.001; r  = 0.60, p  < 0.001) and the SD of HbA1c levels ( r  = 0.53, p  = 0.001; r  = 0.73, p  < 0.001; r  = 0.69, p  < 0.001; r  = 0.43, p  = 0.01) but not with HbA1c level. Relationships between 8-iso-PGF2α and MAGE or the SD of HbA1c levels remained significant after adjusting for other markers of diabetic control ( R 2  = 0.684, R 2  = 0.595, p  < 0.001, respectively). Both acute and chronic blood glucose variability can induce oxidative stress and chronic inflammation.