Correlation between glucose fluctuations and carotid intima-media thickness in type 2 diabetes

Abstract Aims To evaluate the relationship between blood glucose fluctuations and carotid atherosclerosis (AS) in type 2 diabetic patients. Methods A case-control study included 36 patients with type 2 diabetes and 10 controls. According to the levels of carotid intima-media thickness (CIMT), 36 diabetic patients were classified into two groups, the diabetes mellitus without atherosclerosis (DM − AS, n  = 20) and diabetes mellitus with atherosclerosis (DM + AS, n  = 16). The glucose excursions were assessed by the following parameters obtained from continuous glucose monitoring system for 72 h: the mean blood glucose (MBG) and its standard deviation (SD), the area under the ROC curve when the blood glucose was higher than 7.8 mmol/L (AUC7.8), the mean amplitude of glycemic excursion (MAGE), the mean of daily differences (MODD), and the largest amplitude of glycemic excursion (LAGE). Results The levels of MBG, SD, MAGE, LAGE, and AUC7.8 were gradually increased with the progression of atherosclerosis ( P R  = 0.58, P R  = 0.50, P R  = 0.34, P  = 0.021), and the LAGE ( R  = 0.31, P  = 0.035). Conclusion These results suggest that glucose fluctuations may accelerate atherogenesis in older type 2 diabetic patients who had a longer duration.