Average Daily Risk Range-Index of Glycemic Variability-Related Factor in Type 2 Diabetic Inpatients

Abstract

Background: It is known that chronic sustained hyperglycemia and its consequent oxidative stress causes diabetic complication in type 2 diabetes. It has been further proven that glycemic variability causes oxidative stress. The aim of this study is to measure the average daily risk range (ADDR)-index of glycemic variability, and to evaluate relevant variables. Methods: We measured the blood glucose level of type 2 diabetic patients who were treated with multiple daily injections from January to July, 2008. The blood glucose levels were checked four times a day for 14 days and were conversed according to the ADRR formula. The degree of glycemic variability was categorized into non-fluctuation and fluctuation groups. We collected patient data on age, sex, duration of diabetes, body mass index, HOMAIR, HOMAβcell and HbA1c. Results: A total of 97 patients were enro lled in this study. The mean ag e, duration of diabetes, HbA1c and mean ADRR were 57.6 ± 13.4, 11.5 ±8.5 years, 10.7 ± 2.5%, and 26.6 ± 9.8, respectively. We classified 18.5% of the patients to the non-fluctuation group, and 81.5% to the flu ctuation group. ADRR was significantly correlated with duration of diabetes, fasting and postprandial glucose, fructosamine, HbA1c and BMI and HOMAβcell. In addition, this study confirmed that BMI, HOMAβcell and HbA1c were ADRR-related independent variables. Conclusion: ADRR can be used as an index for blood glucose fluctuation in type 2 diabetic patients. Measuring ADRR in patients with low BMI and a long duration of diabetes is helpful to improve the effectiveness of their care. (Korean Diabetes J 33:31-39, 2009)