Glycaemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in Type 2 diabetes

Abstract

This study suggests that glycaemic variability influences endothelial function even in non-diabetic subjects. Such variability may explain the increased cardiovascular risk observed in patients prior to developing overt Type 2 diabetes.

Hypoglycemia, but Not Glucose Variability, Relates to Vascular Function in Children with Type 1 Diabetes

“…4 Glucose variability assessed using CGMS also relates to vascular function in healthy adults and adults with metabolic syndrome with or without type 2 diabetes. 13 In addition, fluctuations in blood glucose levels during a hyperglycemic-euinsulinemic clamp relate to vascular endothelial function in healthy adults and adults with type 2 diabetes only treated with diet. 14 This highlights possible differences in the role of glucose variability on cardiovascular disease in T1D versus type 2 diabetes.…”

“…6 In adults with metabolic syndrome and type 2 diabetes, glucose variability measured by CGMS relates to endothelial dysfunction. 13 In healthy adults and adults with type 2 diabetes, fluctuations in blood glucose levels during a hyperglycemic-euinsulinemic clamp have more deleterious effects than sustained high glucose on endothelial dysfunction and oxidative stress. 14 In vitro studies have shown that fluctuating blood glucose levels increase markers of endothelial dysfunction, including vascular cell adhesion molecules, intracellular adhesion molecules, and E-selectin.…”

Self-Monitoring of Blood Glucose in Type 2 Diabetes: Recent Studies

“…20 The importance of SMBG in T2DM is also underlined by growing evidence that glycemic variability independently increases the risk for endothelial dysfunction, cognitive impairment, vascular complications, and mortality. [21][22][23][24] It is currently hypothesized that glycemic variability contributes to diabetes complications independently of glycosylated hemoglobin (HbA1c) levels. [24][25][26] To assess diurnal glucose excursions, SMBG has also been established as a useful tool.…”

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“…Therefore, today, various methods showing glycemic variability are used for the follow-up of diabetes control and in order to predict possible complications. Increased glycemic fluctuations have been demonstrated to cause more severe endothelial damage and oxidative stress, resulting in serious cardiovascular complications, compared to constantly high blood glucose levels (12,(14)(15)(16). Today, the methods used in evaluation of the glycemic variability are MAGE, 1.5-anhydroglucitol and fructosamine (7,(17)(18)(19).…”