Correlations of the glycemic variability with oxidative stress and erythrocytes membrane stability in patients with type 1 diabetes under intensive treatment

Rodrigues, Ricardo; Medeiros, Luciana Alves de; Cunha, Lucas Moreira; Garrote-Filho, Mário da Silva; Neto, Morun Bernardino; Jorge, Paulo; Resende, Elmiro Santos; Penha-Silva, Nilson

doi:10.1016/j.diabres.2018.01.031

Cited by 35 publications

(22 citation statements)

References 38 publications

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“…Mechanisms for hypoglycaemia-induced vascular damage include the induction of an inflammatory and prothrombotic milieu due to low glucose levels [ 8 ]. To further complicate matters, large fluctuations in glucose control, typically seen in individuals with inadequate insulin dosing, are also thought to be associated with vascular damage through increased oxidative stress and an enhanced inflammatory response [ 9 ]. Our understanding of the mechanistic pathways linking glucose variability with increased cardiovascular risk is incomplete and causality has yet to be fully proven, but the evidence behind this being a contributory factor in the development of cardiovascular disease (CVD) is growing [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Metabolic Control in Type 1 Diabetes: Is Adjunctive Therapy the Way Forward?

et al. 2018

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Despite advances in insulin therapies, patients with type 1 diabetes (T1DM) have a shorter life span due to hyperglycaemia-induced vascular disease and hypoglycaemic complications secondary to insulin therapy. Restricting therapy for T1DM to insulin replacement is perhaps an over-simplistic approach, and we focus in this work on reviewing the role of adjuvant therapy in this population. Current data suggest that adding metformin to insulin therapy in T1DM temporarily lowers HbA1c and reduces weight and insulin requirements, but this treatment fails to show a longer-term glycaemic benefit. Agents in the sodium glucose co-transporter-2 inhibitor (SGLT-2) class demonstrate the greatest promise in correcting hyperglycaemia, but there are safety concerns in relation to the risk of diabetic ketoacidosis. Glucagon-like peptide-1 agonists (GLP-1) show a modest effect on glycaemia, if any, but significantly reduce weight, which may make them suitable for use in overweight T1DM patients. Treatment with pramlintide is not widely available worldwide, although there is evidence to indicate that this agent reduces both HbA1c and weight in T1DM. A criticism of adjuvant studies is the heavy reliance on HbA1c as the primary endpoint while generally ignoring other glycaemic parameters. Moreover, vascular risk markers and measures of insulin resistance—important considerations in individuals with a longer T1DM duration—are yet to be fully investigated following adjuvant therapies. Finally, studies to date have made the assumption that T1DM patients are a homogeneous group of individuals who respond similarly to adjuvant therapies, which is unlikely to be the case. Future longer-term adjuvant studies investigating different glycaemic parameters, surrogate vascular markers and harder clinical outcomes will refine our understanding of the roles of such therapies in various subgroups of T1DM patients.

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Section: Introductionmentioning

confidence: 99%

Metabolic Control in Type 1 Diabetes: Is Adjunctive Therapy the Way Forward?

et al. 2018

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“…Apart from hyperglycemia itself, glycemic variability is also considered to be related to disturbed hormones and oxidative stress. Studies have reported that glycemic variability was correlated to oxidative stress and erythrocyte membrane stability [24], and improvement in glycemic variability reduced oxidative stress [25]. Based on this evidence, we suspect a potential association between glycemic variability and the development of malignancies through hormonal pathways and oxidative stress in people without diabetes.…”

Section: Introductionmentioning

confidence: 76%

Glycemic variability and subsequent malignancies among the population without diabetes

Kobayashi

Noto

Takahashi

et al. 2020

Diabetes Research and Clinical Practice

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“…This is likely because RBCs are under oxidative stress when blood glucose is elevated, which activates the WBCs in circulation and the innate immune system. 36 , 48 This may also mean that during the increase of blood glucose in the body, morphological and functional changes of RBCs, oxidation and anti-oxidation of tissues and organs, and pro-inflammatory and anti-inflammatory reactions have already occurred. 48 , 49…”

Section: Discussionmentioning

confidence: 99%

<p>The Product of Red Blood Cells and Hematocrit Can Be Used as a Novel Indicator of Impaired Fasting Blood Glucose Status</p>

Feng¹,

Chen²,

Chen³

et al. 2020

DMSO

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Objective To explore whether the red blood cell count multiplied by hematocrit index (RBCHct) in blood routine parameters can indicate the risk of impaired fasting blood glucose (IFG), and whether it is related to insulin resistance and inflammation. Methods In this cross-sectional study, previous history of diabetes was excluded, and people with normal and impaired IFG were included. We use Spearman analysis to evaluate the correlation between RBCHct index and fasting plasma glucose, insulin resistance homeostasis model assessment (HOMA-IR), and hypersensitive C-reactive protein (hs-CRP). Binary logistic regression analysis was used to evaluate the RBCHct index for assessing the potential risk of IFG, and the receiver operating characteristic (ROC) curve was used to evaluate the RBCHct index for diagnosing insulin resistance and chronic low-grade inflammatory efficacy among those with IFG. Results Correlation analysis showed that the RBCHct index and fasting plasma glucose (r=0.088, P=0.003); HOMA-IR (r=0.199, P<0.001); and hs-CRP (r=0.097, P=0.001) were positively correlated. After adjusting for confounding factors, the risk of IFG in the third and fourth quartiles of the RBCHct index increased to 1.889 and 3.048 times. The area under the ROC curve of the RBCHct index for diagnosis of insulin resistance state (HOMA-IR) was 0.695 (p<0.001), and the area under the ROC curve of the RBCHct index for the diagnosis of chronic low-inflammatory state (hs-CRP) was 0.641 (P=0.010). Conclusion The RBCHct index may be a potential indicator for assessing the risk of prediabetes and is closely related to whether the body is in a state of insulin resistance and inflammation under IFG.

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Correlations of the glycemic variability with oxidative stress and erythrocytes membrane stability in patients with type 1 diabetes under intensive treatment

Cited by 35 publications

References 38 publications

Metabolic Control in Type 1 Diabetes: Is Adjunctive Therapy the Way Forward?

Metabolic Control in Type 1 Diabetes: Is Adjunctive Therapy the Way Forward?

Glycemic variability and subsequent malignancies among the population without diabetes

<p>The Product of Red Blood Cells and Hematocrit Can Be Used as a Novel Indicator of Impaired Fasting Blood Glucose Status</p>

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