Abstract
To define the features of glycemic variations in drug naïve type 2 diabetic (T2D) patients with different HbA1c values using continuous glucose monitoring (CGM), a total of 195 drug naïve T2D patients were admitted. The subjects were divided into the following groups: lower HbA1c values (≤8%), moderate HbA1c values (>8% and ≤10%), and higher HbA1c values (>10%). The patients underwent oral glucose tolerance tests and were then subjected to 3-day CGM. The primary endpoint was the differences in the 24-hr mean amplitude of glycemic excursions (MAGE) in patients with different HbA1c values. Patients with higher HbA1c values had larger MAGEs than those in the moderate and lower groups (7.44 ± 3.00 vs. 6.30 ± 2.38, P < 0.05, 7.44 ± 3.00 vs. 5.20 ± 2.35, P < 0.01, respectively). The 24-hr mean glucose concentrations increased incrementally in the patients with lower, moderate and higher HbA1c values. Moreover, the patients with higher HbA1c values exhibited higher peak glucose concentrations and prolongation in the time to peak glucose. Patients with higher HbA1c values had larger MAGE compared with those with lower and moderate HbA1c values. Our data indicated patients with higher HbA1c values should receive special therapy aimed at reducing the larger glycemic variations.
Highlights
Large glucose fluctuations in patients with may have implications for the risk for long-term diabetic complications[1, 2]
We did not observe a difference in HOMA-IR between the M and L groups (Table 1). This relatively large study revealed a novel observation that glycemic variations gradually increased with HbA1c values in drug naïve type 2 diabetes (T2D) patients
We observed that drug naïve patients with HbA1c values above 10% exhibited larger blood glucose fluctuations, higher peak glucose concentrations, and prolongation in the glucose time to peak after breakfast
Summary
Large glucose fluctuations in patients with may have implications for the risk for long-term diabetic complications[1, 2]. Acute glucose fluctuations during postprandial periods other than chronic hyperglycemia have been shown to play an important role in oxidative stress in patients with type 2 diabetes (T2D)[3]. Reductions in HbA1c value in patients with diabetes leads to a reduction in the risk of death, myocardial infarction, and microvascular complications[7]. Glycemic fluctuations should be considered when constructing strategies aimed to reduce the burden of diabetic complications as well as HbA1c values[2]. We determined 24-hr glycemic variations using CGM in drug naïve T2D patients with different or even similar HbA1c values
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