Glycemic Variability, Oxidative Stress, and Impact on Complications Related to Type 2 Diabetes Mellitus

Valente, Tatiana; Arbex, Alberto Krayyem

doi:10.2174/1573399816666200716201550

Cited by 25 publications

(21 citation statements)

References 123 publications

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“…Previous studies demonstrated that GV was associated with the risk of both hyperglycemia and hypoglycemia [ 32 , 82 – 84 ]. Increasing evidence has shown that GV, hypoglycemia and hyperglycemia are all closely related to oxidative stress [ 85 , 86 ]. It is noteworthy that transient hyperglycemia has been shown to induce even more vascular damage than sustained hyperglycemia, mainly mediated by oxidative stress [ 87 , 88 ].…”

Section: Relevant Mechanisms Of Gv In Diabetic Macrovascular and Micrmentioning

confidence: 99%

Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications

Sun

Luo

Zhou

2021

Cardiovasc Diabetol

104

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Diabetes mellitus is the major risk factor for the development of macrovascular and microvascular complications. It is increasingly recognized that glycemic variability (GV), referring to oscillations in blood glucose levels and representing either short-term or long-term GV, is involved in the pathogenesis of diabetic complications and has emerged as a possible independent risk factor for them. In this review, we summarize the metrics and measurement of GV in clinical practice, as well as comprehensively elaborate the role and related mechanisms of GV in diabetic macrovascular and microvascular complications, aiming to provide the mechanism-based therapeutic strategies for clinicians to manage diabetes mellitus.

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Section: Relevant Mechanisms Of Gv In Diabetic Macrovascular and Micrmentioning

confidence: 99%

Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications

Sun

Luo

Zhou

2021

Cardiovasc Diabetol

104

View full text Add to dashboard Cite

show abstract

“…Similarly, another recent study showed that a higher acute GV as measured by MAGE was correlated with the severity of sepsis as evaluated by the SOFA scores [ 36 ]. Moreover, it has been well recognized that high glycemic fluctuation is associated with activation of oxidative stress [ 37 ] and inflammation [ 38 ], two key pathophysiological factors involved in the exacerbation of sepsis and deterioration of subsequent organ function [ 39 ]. Besides, findings from recent studies also showed that increased acute glycemic fluctuation is associated with the severity and poor prognosis of other infectious diseases, such as influenza [ 40 ] and Coronavirus Disease 2019 (COVID-19) [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Acute glycemic variability and risk of mortality in patients with sepsis: a meta-analysis

Li¹,

Zhang

Chen³

et al. 2022

Diabetol Metab Syndr

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Background Acute glycemic variability (GV) has been correlated with the severity of sepsis. The aim of the study was to evaluate the potential association between acute GV and mortality risk in patients with sepsis. Methods Cohort studies comparing the risk of death within 3 months between septic patients with higher versus lower acute GV were retrieved by systematic search of Medline, Embase, Web of Science, Wanfang and CNKI databases. We used a random-effect model to pool the data by incorporating the between-study heterogeneity. Sensitivity analyses were performed to evaluate the stability of the findings. Results Ten studies including 4296 patients were available for the meta-analysis. Pooled results showed that septic patients with higher acute GV had significantly increased mortality risk compared to those with lower acute GV, as evidenced by results using different parameters including standard deviation of blood glucose (SDBG, risk ratio [RR]: 1.74, 95% confidence interval [CI] 1.36–2.24, p < 0.001; I2 = 0%), coefficient of variation of blood glucose (RR: 1.91, 95% CI 1.57–2.31, p < 0.001; I2 = 0%), mean amplitude of glycemic excursion (RR: 1.81. 95% CI 1.36–2.40, p < 0.001; I2 = 0%), and glycemic lability index (RR: 2.52, 95% CI 1.72–3.68, p < 0.001; I2 = 0%). Sensitivity analyses by excluding one study at a time did not significantly affect the results (p all < 0.05). Conclusions Higher acute GV may be a predictor of mortality risk in patients with sepsis.

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“…When comparing diabetic patients receiving combined therapy to those receiving metformin or glipizide monotherapy, the results were more efficient for the diabetic rats. Nowadays, oxidative stress in diabetes is considered the basis for the pathogenesis of all diabetes-related complications [51]. Glycemic control, lipoprotein profile and hepatorenal function in diabetic patients are all adversely affected by increased free radical production.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Treatment of Metformin and Glipizide on Oxidative Stress, Lipid Profile and Renal Function in a Rat Model with Diabetes Mellitus

et al. 2022

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Background: Oxidative stress, lipid profile and renal functions are well-known conventional risk factors for diabetes mellitus (DM). Metformin and gliclazide are popularly used monotherapy drugs for the treatment of DM. Aims: This study aims to assess the short-term treatment of single and dual therapy of glipizide/metformin on oxidative stress, glycemic control, serum lipid profiles and renal function in diabetic rats. Methods: DM was induced in rats with streptozotocin (STZ), then five different treatments were applied, including group I (untreated healthy control), group II (diabetic and untreated), group III (diabetic and treated with metformin), group IVI (diabetic and treated with glipizide) and group V (diabetic and treated with a combination of metformin and glipizide. Lipid peroxidation (LPO), nitric oxide (NO), total antioxidant capacity (TAC), fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine and urea were measured. Results: Compared to the untreated DM group, FBG and HbA1c were significantly reduced in the DM groups (p < 0.01) treated with metformin (159.7 mg/dL & 6.7%), glipizide (184.3 mg/dL & 7.3%) and dual therapy (118 mg/dL & 5.2%), respectively. Treatment with dual therapy and metformin significantly decreased LPO and NO levels but increased TAC in diabetic rats more than glipizide compared to untreated diabetic rats. Furthermore, metformin (19.8 mg/dL, p < 0.001), glipizide (22.7 mg/dL, p < 0.001), and dual therapy (25.7 mg/dL, p < 0.001) significantly decreased urea levels in the treated rats compared to untreated DM rats (32.2 mg/dL). Both drugs and their combination exhibited a substantial effect on total cholesterol, HDL, LDL and atherogenic index. Conclusions: These results suggest that the therapeutic benefits of metformin and glipizide are complementary. Metformin exhibited superior performance in improving glycemic control and decreasing oxidative stress, while glipizide was more effective against dyslipidemia. These findings could be helpful for the treatment of future vascular patients, antilipidemic medicines and antioxidant therapy to improve the quality of life.

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Glycemic Variability, Oxidative Stress, and Impact on Complications Related to Type 2 Diabetes Mellitus

Cited by 25 publications

References 123 publications

Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications

Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications

Acute glycemic variability and risk of mortality in patients with sepsis: a meta-analysis

Short-Term Treatment of Metformin and Glipizide on Oxidative Stress, Lipid Profile and Renal Function in a Rat Model with Diabetes Mellitus

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