Activation of Oxidative Stress by Acute Glucose Fluctuations Compared With Sustained Chronic Hyperglycemia in Patients With Type 2 Diabetes

Abstract

Glucose fluctuations during postprandial periods and, more generally, during glucose swings exhibited a more specific triggering effect on oxidative stress than chronic sustained hyperglycemia. The present data suggest that interventional trials in type 2 diabetes should target not only hemoglobin A1c and mean glucose concentrations but also acute glucose swings.

Acute Kidney Injury in Diabetic Patients With Acute Myocardial Infarction: Role of Acute and Chronic Glycemia

“…Our data indicate that estimation of chronic glycemia is essential to reveal true acute glycemic rise in DM patients; however, we were unable to identify which combination of acute and chronic glycemia is more closely associated with AKI risk. Aside from the aforementioned combination, our observations are in agreement with previous experimental and clinical studies on AKI demonstrating that acute glycemic changes have a more detrimental effect on renal function compared with absolute high levels at admission 33, 34, 35…”

“…Nevertheless, we can infer that a causal link between acute glycemic rise and AKI may exist, as this relationship remained significant even after adjustment for major clinical confounders. In agreement with this hypothesis, experimental and clinical evidence has shown that an acute increase of plasma glucose suppresses flow‐mediated vasodilatation, likely through increased production of oxygen‐derived free radicals, and increases oxidative stress34, 35 that may exacerbate the deleterious effects of contrast agents on the kidney. Moreover, acute hyperglycemia may induce osmotic diuresis, resulting in volume depletion and dehydration and further increasing AKI risk and severity.…”

“…Moreover, assessment may be used to customize glucose control. The detrimental effects of glycemic disorder are not limited to stress hyperglycemia; they also include fluctuations of glycemic values, with acute glucose changes in both directions 35. Accordingly, it has been shown that intensive lowering of glycemia may have a detrimental effect in patients with high glycemic values at admission but without stress hyperglycemia 36, 37.…”

Mediterranean diet supplemented with coenzyme Q10 induces postprandial changes in p53 in response to oxidative DNA damage in elderly subjects

“…Dietary and lifestyle factors play a central role in the etiology of postprandial dysmetabolism (O'Keefe and Bell 2007). In Western societies, high-calorie meals rich in processed foods and drinks, usually rich in saturated fatty acids (SFA) can lead to exaggerated postprandial elevations in blood glucose and triglycerides, and overwhelms the metabolic capabilities of the mitochondria creating free radicals (Monnier et al 2006). The postprandial oxidant stress acutely triggers atherogenic changes, including increases in lowdensity lipoprotein (LDL) oxidation, sympathetic tone, vasoconstriction, and thrombogenicity.…”

Treatment thresholds for hyperglycemia in critically ill patients with and without diabetes

“…The degree of blood glucose change (glycemic variability) has been demonstrated to be an independent predictor of poor outcome in critically ill patients [13]. In patients with type II diabetes, glycemic variability has been demonstrated to increase oxidative stress [14]. Increased oxidative stress can result in endothelial dysfunction and contribute to vascular damage.…”