Dynamic evaluation of blood glucose fluctuations in type 2 diabetic and normal subjects

Ming YU; Jian ZHOU; Yichang ZHOU; Fengdi LU

ABSTRACT

BACKGROUND:

Dynamic glucose monitoring can reflect the fluctuation of blood glucose by successive examination at the interval of 5 minutes,which contributes to the overall and objective evaluation of glucose metabolism.

OBJECTIVE:

To investigate the tendency and characteritics of blood glucose fluctuation in type 2 diabetic and normal subjects.

DESIGN:

A case-controlled retrospective experiment based on patients and healthy controls.

SETTING:

Endocrine Metabolism Ward and Clinic of Sixth People's Hospital Affiliated to Shanghai Jiaotong University.

PARTICIPANTS:

Totally 47 patients were newly diagnosed as having type 2 diabetes mellitus at Endocrine Metabolism Ward and Clinic, Sixth People's Hospital Affiliated to Shanghai Jiaotong University, between December 2002 and July 2004. They had not received intervention (diet, exercise or medicine) before. Those with acute complications such as ketoacidosis and hyperosmolar coma were excluded. Meanwhile, 43 healthy controls were selected from those coming for routine health examinations, and they had no family history of diabetes, and impaired fasting glucose and impaired glucose tolerance were excluded. Their lipid and liver and kidney indexes as well as blood pressure were within normal range. They all signed informed consent.

METHODS:

Totally 43 normals and 47 patients with type 2 diabetes mellitus were subjected to dynamic glucose monitoring for consecutive (71±10) hours, and (846±122) results of glucose level were obtained.MAIN OUTCOME

MEASURES:

The average glucose level, diurnal maximum and minimum, fluctuation amplitude, the average preprandial and postprandial glucose values and the time percentage of diurnal glycemic fluctuations.

RESULTS:

According to the objective of this study, all subjects went through the experiment without loss. ① The fluctuation tendency of blood glucose in two groups The average glucose, diurnal maximum and maximum fluctuation amplitude in type 2 diabetes mellitus group were [(12.2±2.6) mmol/L], [(18.5±2.7) mmol/L] and [(11.2±2.8) mmol/L,respectively], which were significantly higher than those in control group [(5.3±0.5), (7.8±1.4) and (3.9±1.6) mmol/L](t=16.68, 23.04, 15.14;P ＜ 0.001). ② The percentage of diurnal glycemic fluctuations time The time percentage of glycemic fluctuations within 2.8-7.8 mmol/L was 99％ (87％-100％) in control group, 95％ (28％-100％) and 62％ (6％-100％) when blood glucose.was increased to ＞ 7.8 mmol/L or ＞ 11.1 mmol/L in type 2 diabetes mellitus group.

CONCLUSION:

Blood glucose in type 2 diabetes mellitus has been proved to fluctuate at a relatively higher level than that of normals, with greater fluctuation amplitude.Dynamic glucose monitoring is benefical to evaluating the tendency and characteritics of blood glucose fluctuations in type 2 diabetic and normal subjects.