Glycaemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in Type 2 diabetes

• Published in: Diabetic medicine 2010-08, Vol.27 (8), p.872-878
• Main Authors: Buscemi, S., Re, A., Batsis, J. A., Arnone, M., Mattina, A., Cerasola, G., Verga, S.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Atherosclerosis - etiology; Atherosclerosis - physiopathology; Biological and medical sciences; Blood Glucose - metabolism; Body Mass Index; diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - etiology; Diabetic Angiopathies - metabolism; Diabetic Angiopathies - physiopathology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; endothelial function; Endothelium, Vascular - metabolism; Endothelium, Vascular - physiopathology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; glycaemic variability; Humans; intima-media thickness; Male; Medical sciences; metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - metabolism; Metabolic Syndrome - physiopathology; Middle Aged; Monitoring, Ambulatory; Obesity - complications; Obesity - metabolism; Risk Factors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2010.03059.x

Diabet. Med. 27, 872–878 (2010) Aims  Subjects who are at increased risk of developing diabetes may have increased glycaemic variability associated with endothelial dysfunction and possibly subclinical atherosclerosis, which may lead to increased cardiovascular risk observed at the time of diabetes diagnosis. To investigate this hypothesis, we measured endothelial function, carotid intima‐media thickness and glycaemic variability using 48‐h continuous subcutaneous glucose monitoring in 3 groups of overweight or obese subjects – those without the metabolic syndrome, and those with the metabolic syndrome with or without newly diagnosed Type 2 diabetes. Methods  Consecutive subjects, aged 30–65 years with a body mass index ≥ 25 kg/m2 were recruited. Patients were classified as with or without the metabolic syndrome,or as metabolic syndrome with newly diagnosed Type 2 DM. Glycaemic variability was calculated in terms of the coefficient of variation. Endothelial function was measured using brachial artery flow‐mediated dilation. Results  We identified 75 subjects. Mean flow mediated dilation decreased (P