Relationship between blood glucose variability and microalbuminuria in type 2 diabetic patients with well-controlled glycosylated hemoglobin

Abstract

To investigate the relationship between the blood glucose variability and microalbuminuria (MAU) in type 2 diabetic patients with well-controlled glycosylated hemoglobin (HbA1c) and the influencing factors of blood glucose variability. One hundred and seventy-six type 2 diabetic patients with HbA1c under 6.5% and 48 subjects with normal glucose regulation were monitored using the continuous glucose monitoring system (CGMS). The mean blood glucose (MBG) and mean amplitude of glucose excursions (MAGE) were analyzed. (1) The MBG and MAGE levels of type 2 diabetic patients were (7.0+/-0.9) and (3.8+/-2.5) mmol/L respectively, both higher than those of the subjects with normal glucose regulation [(5.4+/-0.6) and (2.0+/-0.7) mmol/L respectively, both P<0.01]. (2) The incidence ratio of MAU of the patients with ascended MAGE level was 18.7%, significantly higher of those with normal MAGE (7.1%, P<0.05). (3) The MAGE level was positively correlated with age, duration of diabetes, and systolic blood pressure, and negatively correlated with glomerular filtration rate and the levels of fasting and postprandial C-peptide. Multivariant regression analyses indicated that duration of diabetes and the level of postprandial C-peptide 30 min after meal were the independent influential factors of MAGE. (4) In the type 2 diabetic patients, the MAGE of the MAU group was higher than that of the non-MAU group (P<0.05). Logistic regression analyses indicated that diastolic blood pressure and MAGE were the risk factors of MAU (OR=1.201 and 1.357, both P<0.05). In well-controlled patients with type 2 diabetes, blood glucose variability is one of the risk factors for MAU, duration of diabetes and early stage of insulin secretion function are the main factors influencing glycemic variability.