Analysis For Glycemic Fluctuation Among Hospitalized Patients With Type 2 Diabetes

Aims: To investigate the associated factors of glycemic fluctuation among hospitalized patients with type 2 diabetes,and to explore the correlation between glycemic fluctuation and diabetic chronic complications.Methods:(1)A total of 155 hospitalized patients with type 2 diabetes underwent dynamic blood glucose monitoring for 72 hours by continuous glucose monitoring system(CGMS).The subjects were divided into two groups according to the mean amplitude of glycemic excursion(MAGE): the group of MAGE?3.9mmol/L and the group of MAGE<3.9mmol/L.Potential associated factors of glycemic fluctuation were examined using logistic regression models.(2)The subjects were screened for diabetic chronic complications,including the diabetic at-risk foot,diabetic retinopathy and carotid ultrasound examination,and further classified into two subtypes:with or without diabetic chronic complications,respectively.Correlation between MAGE and diabetic chronic complications were examined using logistic regression models.Result:(1)In the final sample of 155 individuals,the pecentage of MAGE?3.9mmol/L was 46.5%(72/155).The risk factors of MAGE including gender,diabetic duration,waistline,Hb A1 c and HDL cholesterol levels(P<0.05).Moreover,Hb A1c?7%(odds ratio [95% confidence interval],4.80[1.78-12.96]),waistline<90cm(3.50[1.27-9.63]),duration of diabetes?10 years(2.63 [1.14-6.08]])and female(2.43[1.06-5.55])may be the independent influcing factors for MAGE.(2)The prevalence of diabetic retinopathy was positively correlated with MAGE?3.9mmol/L(5.48[1.61-18.61]),while diabetic neuropathy and diabetic macroangiopathy may not be associated with it.Conclusions:Hospitalized patients with type 2 diabetes always have sharp glycemic fluctuations.Hb A1c?7%,waistline<90cm,duration of diabetes?10 years and female are independent influcing factors for the glycemic fluctuation.It may also associated with dyslipidemia.In addition,glycemic fluctuation may be closely related to the development of diabetic retinopathy.Reducing glycemic fluctuation may help to reduce the prevalence of diabetic retinopathy and improve the prognosis of patients with type 2 diabetes.