Association Between Visit-to-visit Blood Pressure Variability And Blood Glucose Control Among T2DM Patients Within Shanghai Community Management

Objective Except the mean of blood pressure(BP),the fluctuation of BP in diabetic patients is also of great significance for blood glucose control.The study aimed to explore the relationship between BP fluctuation and blood glucose control to optimize their blood glucose management by different risk levels.Methods In the first part,after the prevalence of hypertension and diabetes,the relationship between hypertension and diabetes was explored by logistic regression in the elderly people who underwent physical examination in Changning district of Shanghai.Then,Logistic regression was conducted to explore the correlation between average successive variability(ASV)of SBP and fasting plasma glucose(FPG)wellcontrol rate in T2 DM patients in Shanghai Changning district.In the second part,cluster analysis was performed on the SBP fluctuation statistics screened by factor analysis to obtain BP fluctuation groups,and the correlation between BP fluctuation and FPG control was explored through the generalized estimation equation.External validation was performed in patients with T2 DM in Xuhui and Putuo district.Results(1)In the Changning elderly population,prevalence of hypertension and diabetes was 45.2% and 18.1%,respectively.After adjusting for the confounding factors,prevalence of diabetes in those with hypertension was about 2 times of those without,with OR and 95% confidence interval(CI): 1.88 [1.49,2.37].(2)T2DM patients in the Changning district was divided into 3 groups("BP stable group","BP slightly fluctuating group" and "BP highly fluctuating group")according to ASV of SBP.After adjusting for confounders,the risk of poor blood glucose control in the " BP highly fluctuating group " increased by 20%(OR = 1.20,95%CI =1.04-1.38).In the external validation,consistent conclusions were obtained.(3)Further,cluster analysis was conducted on the 3 BP fluctuation statistics obtained by factor analysis to obtain BP fluctuation groups.FPG in "BP slightly fluctuating group" and "BP highly fluctuating group" was 0.062mmol/L and 0.273mmol/L higher than that in "BP stable group".Results were also validated in Xuhui and Putuo district.Conclusion High BP fluctuation in community-managed T2 DM patients was likely to be one of the independent risk factors for good blood glucose control.Diabetic patients with high BP fluctuation need to focus on monitoring their blood glucose changes at the same time to prevent the occurrence of other complications.It’s an indication for the which means significance of public health.