Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes
Objective. Type 2 diabetes mellitus (T2DM) is known to be associated with increased cardiovascular risk. The aim of this study was therefore to investigate the independent effects of hyperglycaemia, hypoglycaemia, and glucose variability on microvascular and macrovascular disease in T2DM. Methods. S...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2018/7464320 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832551642294124544 |
|---|---|
| author | Caroline Jane Magri Dillon Mintoff Liberato Camilleri Robert G. Xuereb Joseph Galea Stephen Fava |
| author_facet | Caroline Jane Magri Dillon Mintoff Liberato Camilleri Robert G. Xuereb Joseph Galea Stephen Fava |
| author_sort | Caroline Jane Magri |
| collection | DOAJ |
| description | Objective. Type 2 diabetes mellitus (T2DM) is known to be associated with increased cardiovascular risk. The aim of this study was therefore to investigate the independent effects of hyperglycaemia, hypoglycaemia, and glucose variability on microvascular and macrovascular disease in T2DM. Methods. Subjects with T2DM of <10 years duration and on stable antiglycaemic treatment underwent carotid intima-media thickness (CIMT), ankle-brachial index (ABI), albumin-creatinine ratio (ACR), and HbA1c measurement, as well as 72-hour continuous glucose monitoring. Macrovascular disease was defined as one or more of the following: history of ischaemic heart disease (IHD), cerebrovascular accident (CVA), ABI < 0.9, or abnormal CIMT. Results. The study population comprised 121 subjects with T2DM (89 males : 32 females). The mean age was 62.6 years, and the mean DM duration was 3.7 years. Macrovascular disease was present in 71 patients (58.7%). In multivariate logistic regression analysis, body surface area (BSA) (OR 18.88 (95% CI 2.20–156.69), p=0.006) and duration of blood glucose (BG) < 3.9 mmol/L (OR 1.12 (95% CI 1.014–1.228), p=0.024) were independent predictors of macrovascular disease. BSA (OR 12.6 (95% CI 1.70–93.54), p=0.013) and duration of BG < 3.9 mmol/L (OR 1.09 (95% CI 1.003–1.187), p=0.041) were independent predictors of abnormal CIMT. Area under the curve for BG > 7.8 mmol/L (β = 15.83, p=0.005) was the sole independent predictor of albuminuria in generalised linear regression. Conclusions. This study demonstrates that hypoglycaemia is associated with the occurrence of atherosclerotic disease while hyperglycaemia is associated with microvascular disease in a Caucasian population with T2DM of recent duration. |
| format | Article |
| id | doaj-art-e961b695a43e41fc8bc468c4ddab866a |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-e961b695a43e41fc8bc468c4ddab866a2025-02-03T06:01:07ZengWileyJournal of Diabetes Research2314-67452314-67532018-01-01201810.1155/2018/74643207464320Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 DiabetesCaroline Jane Magri0Dillon Mintoff1Liberato Camilleri2Robert G. Xuereb3Joseph Galea4Stephen Fava5Department of Cardiology, Mater Dei Hospital and University of Malta, Msida, MaltaMater Dei Hospital, Msida, MaltaStatistics & Operations Research, Faculty of Science, University of Malta, Msida, MaltaDepartment of Cardiology, Mater Dei Hospital, Msida, MaltaMater Dei Hospital and University of Malta, Msida, MaltaMater Dei Hospital and University of Malta, Msida, MaltaObjective. Type 2 diabetes mellitus (T2DM) is known to be associated with increased cardiovascular risk. The aim of this study was therefore to investigate the independent effects of hyperglycaemia, hypoglycaemia, and glucose variability on microvascular and macrovascular disease in T2DM. Methods. Subjects with T2DM of <10 years duration and on stable antiglycaemic treatment underwent carotid intima-media thickness (CIMT), ankle-brachial index (ABI), albumin-creatinine ratio (ACR), and HbA1c measurement, as well as 72-hour continuous glucose monitoring. Macrovascular disease was defined as one or more of the following: history of ischaemic heart disease (IHD), cerebrovascular accident (CVA), ABI < 0.9, or abnormal CIMT. Results. The study population comprised 121 subjects with T2DM (89 males : 32 females). The mean age was 62.6 years, and the mean DM duration was 3.7 years. Macrovascular disease was present in 71 patients (58.7%). In multivariate logistic regression analysis, body surface area (BSA) (OR 18.88 (95% CI 2.20–156.69), p=0.006) and duration of blood glucose (BG) < 3.9 mmol/L (OR 1.12 (95% CI 1.014–1.228), p=0.024) were independent predictors of macrovascular disease. BSA (OR 12.6 (95% CI 1.70–93.54), p=0.013) and duration of BG < 3.9 mmol/L (OR 1.09 (95% CI 1.003–1.187), p=0.041) were independent predictors of abnormal CIMT. Area under the curve for BG > 7.8 mmol/L (β = 15.83, p=0.005) was the sole independent predictor of albuminuria in generalised linear regression. Conclusions. This study demonstrates that hypoglycaemia is associated with the occurrence of atherosclerotic disease while hyperglycaemia is associated with microvascular disease in a Caucasian population with T2DM of recent duration.http://dx.doi.org/10.1155/2018/7464320 |
| spellingShingle | Caroline Jane Magri Dillon Mintoff Liberato Camilleri Robert G. Xuereb Joseph Galea Stephen Fava Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes Journal of Diabetes Research |
| title | Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes |
| title_full | Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes |
| title_fullStr | Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes |
| title_full_unstemmed | Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes |
| title_short | Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes |
| title_sort | relationship of hyperglycaemia hypoglycaemia and glucose variability to atherosclerotic disease in type 2 diabetes |
| url | http://dx.doi.org/10.1155/2018/7464320 |
| work_keys_str_mv | AT carolinejanemagri relationshipofhyperglycaemiahypoglycaemiaandglucosevariabilitytoatheroscleroticdiseaseintype2diabetes AT dillonmintoff relationshipofhyperglycaemiahypoglycaemiaandglucosevariabilitytoatheroscleroticdiseaseintype2diabetes AT liberatocamilleri relationshipofhyperglycaemiahypoglycaemiaandglucosevariabilitytoatheroscleroticdiseaseintype2diabetes AT robertgxuereb relationshipofhyperglycaemiahypoglycaemiaandglucosevariabilitytoatheroscleroticdiseaseintype2diabetes AT josephgalea relationshipofhyperglycaemiahypoglycaemiaandglucosevariabilitytoatheroscleroticdiseaseintype2diabetes AT stephenfava relationshipofhyperglycaemiahypoglycaemiaandglucosevariabilitytoatheroscleroticdiseaseintype2diabetes |