The Effect Of Blood Glucose Fluctuation On Macroangiopathy In Type 2 Diabetes Mellitus

Objective: To investigate the influence of glucose variability on macroangiopathy in T2 DM.Methods: Follow inclusion and exclusion criteria,403 T2 DM patients admitted to the Affiliated Hospital of Qing Hai University from November 2019 to November 2020 were selected and divided into simple T2 DM without macroangiopathy group(n=114)and T2 DM with macroangiopathy group(n=289).The latter is divided into T2 DM with carotid artery disease group(n= 107),T2 DM with lower limb artery disease group(n=73),and T2 DM with carotid artery disease and lower limb artery disease group(n=109).General data and laboratory indicators of all subjects were collected.Fingertip blood glucose was monitored 7 times a day by SMBG during the first 3 days of hospitalization(blood glucose before 3 meals,2h after meals,and before sleep),and blood glucose fluctuation indexes(including SDBG,LAGE,PPGE,SD-FPG,SD-PPG)were calculated.The divide in general conditions and glucose variability among two groups were compared.Logistic regression was used to analyze the factors affecting macroangiopathy in T2 DM patients.Results:1.The age,course of disease,proportion of hypertension,PPGE,LAGE,SDBG,SD-FPG,Cys C and FIB of T2 DM group were lower than those of T2 DM group with macrovascular disease(P < 0.05).The ALB in T2 DM with macrovascular disease was lower than that in T2 DM group(P < 0.05).There were no statistical differences in gender,BMI,smoking and drinking history,SD-PPG,MBG,MFBG,MPBG,Hb A1 c,HOMA-β,HOMA-IR,TC,TG,LDL-C,HDL-C,TBIL,DBIL,IBIL,Scr,BUN,UA,WBC,Mno,Lym and MHR between the two groups(P > 0.05).2.Contrast of glucose variability indexes among groups with macroangiopathy in different parts: there was no statistical distinction in SD-FPG and SD-PPG among the three groups(P > 0.05);PPGE,LAGE and SDBG in carotid and lower limb artery disease group were higher than those in carotid group and in lower limb artery lesions group(P < 0.05).There was no difference in PPGE,LAGE and SDBG between T2 DM with carotid artery disease group and T2 DM with lower limb artery disease group(P >0.05).3.Logistic regression analysis indicated that disease duration,hypertension and SDBG were risk factors for the occurrence of macroangiopathy in T2 DM patients.(OR values were 1.102,2.401,1.753,P < 0.05)Conclusion:1.Blood glucose fluctuation has an important influence on the occurrence of T2 DM macroangiopathy.The greater the fluctuation range of blood glucose,the more serious the macroangiopathy.2.There was no significant difference in blood glucose fluctuation in T2 DM patients with different sites of macroangiopathy.3.Hypertension,course of disease and SDBG are risk factors for the occurrence of macroangiopathy in T2 DM patients.