The Effect Of Glucose Excursion On Oxidative Stress And Inflammation In Patients With Type 2 Diabetes

BackgroundIn recent years, more and more evidence suggests that postprandial hyperglycaemia may be a cardiovascular risk factor in patients with type 2 diabetes. Oxidative stress and inflammation are involved in the pathogenesis of diabetic complications. However, there is a paucity of clinical data on postprandial oxidative stress and inflammation in subjects with type 2 diabetes.ObjectiveThe primary aim of this study was to investigate the amplitude of glucose excursion, oxidative stress, the level of inflammation in patients with type 2 diabetes. We compare the postprandial effects of a meal on biomarkers of oxidative stress and inflammation in subjects with type 2 diabetes.We also analyze the correlation between glucose excursion,oxidative stress, inflammation and Diabetic Angiopathies.MethodsA total of 106 individuals with type 2 diabetes were enrolled. Diagnosis of diabetes was made according to the World Health Organization criteria of 1999. Subjects with acute infection or inflammation and those whoes physical conditions were not suitable for oral glucose tolerance test were excluded.All the diabetic patients had not received the treatment of antioxidants within the past 1 month before the trial.Clinical data of all the subjects were recorded, such as age, gender, disease duration, blood pressure, height, weight, body mass index (BMI), etc. Blood samples of the same side of the elbow vein were collected at 7:00 AM to measure fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbAlc), uric acid (UA), high sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA),etc. After the fasting blood samples were taken, all of the subjects undertaken the oral glucose tolerance test in which the 75g glucose was replaced by a steamed bread made from 100g flour. The venous plasma glucose and insulin levels were measured at 8:00.9:00 and 10:00 after the meal. Another 2h postprandial blood samples were taken for the measurement of malondialdehyde (MDA). high sensitivity C-reactive protein (hs-CRP). The test of MDA was conducted with the method of thiobarbituric acid index, and hs-CRP with Immunity Turbidimetry Assay. ResultsSubjects were divided into four groups according to their diabetic microangiopathy.Group DM:patients with no diabetic microangiopathy; Group DN:patients with Diabetic Nephropathy; Group DR:patients with Diabetic Retinopathy; Group DA:patients with both DN and DR.1. The plasma glucose and PPGE in group DA are higher than those in group DN and DR, both of which were higher than group DM, the difference was statistically significant (P<0.05); The difference between group DN and group DR was not statistically significant(P>0.05).2. The serum levels of MDA andâ–³MDA values in group DA were higher than those in group DN and DR, both of which were higher than group DM, the difference was statistically significant (P<0.05); The difference between group DN and group DR was not statistically significant(P>0.05).3. The serum levels of hs-CRP in group DA were higher than those in group DN and DR, both of which were higher than group DM, the difference was statistically significant (P<0.05); The difference between group DN and group DR was not statistically significant(P>0.05). The difference betweenâ–³hs-CRP values in the four groups was not statistically significant (P> 0.05).4.â–³MDA values were positively correlated with 2h-postprandial glucose (2h PBG) level and PPGE.5. There was no correlation betweenâ–³hs-CRP and FBG,2hPBG,MBG,PPGE,HbAlc.ConclusionsGlucose excursion was assessed by postprandial glycemic excursion (PPGE). The serum MDA as the biomarker of oxidative stress and hs-CRP of inflammation were measured1. With the increasing severity of diabetic angiopathies in type 2 diabetes, the level of oxidative stress and inflammation also increase correspondingly.2. Postprandial hyperglycemia aggravates the activation of oxidative stress in subjects with type 2 diabetes.3. Postprandial glucose excursion has no significant effect on the inflammatory response within a short time in patients with type 2 diabetes.