Abstract:

Objective To continuously monitor the blood glucose fluctuation of elder patients with type 2 diabetes mellitus, and explore the relationship among glycemic excursion, glycated hemoglobin A1c (HbA1c) and chronic diabetic complications. Methods Seventy elder patients with type 2 diabetes mellitus were enrolled, among whom 35 were complicated with diabetic nephropathy and 30 with diabetic retinopathy. Blood glucose was monitored for 72 h with continuous glucose monitoring system (CGMS), and blood glucose levels of different time points, glycemic excursion of different time stages, postprandial glycemic excursion (PPGE) of different time stages, mean amplitude of glycemic excursion (MAGE) and 24 h mean blood glucose (24 h MBG) levels were obtained. The relationship between HbA1c and glycemic excursion with CGMS was investigated by Pearson analysis, and the influencing factors of diabetic nephropathy and diabetic retinopathy were explored by multivariate Logistic regression analysis. Results HbA1c was positively correlated with blood glucose levels of seven time points, 24 h MBG and glycemic excursion of 3:00 to 6:00 and 19:00 to 20:00 (r>0, P<0.05 or P<0.01), while was not significantly correlated with PPGE (P>0.05). MAGE was significantly positively correlated with blood glucose levels of 13:00 and 19:00 and PPGE (r>0, P<0.05). Glycemic excursion of 0:00 to 3:00 was influencing factors of diabetic retinopathy (P<0.05). Conclusion CGMS can display blood glucose fluctuation in details, and HbA1c may comprehensively reveal blood glucose levels. Blood glucose fluctuation is mainly attributed to PPGE and nighttime glycemic excursion. Diabetic retinopathy may correlate with glycemic excursion.

Key words: continuous glucose monitoring, blood glucose excursion, glycated hemoglobin A1c, type 2 diabetes mellitus, elder