Acute and chronic fluctuations in blood glucose levels can increase oxidative stress in type 2 diabetes mellitus

Abstract

In order to investigate whether short- or long-term glycemic fluctuations could induce oxidative stress and chronic inflammation, we evaluated the relationships between glycemic variability, oxidative stress markers, and high-sensitivity C-reactive protein (hs-CRP). We enrolled 34 patients with type 2 diabetes. As a measure of short-term glycemic variability, mean amplitude of glycemic excursions (MAGE) was computed from continuous glucose monitoring system data. For determining long-term glycemic variability, we calculated the standard deviation (SD) of hemoglobin A1c (HbA1c) levels measured over a 2-year period. Levels of oxidative stress markers: 8-iso-prostaglandin F2α (8-iso-PGF2α), thiobarbituric acid-reactive substance (TBARS), 8-hydroxydeoxyguanosine (8-OHdG), and hs-CRP were measured. MAGE was significantly correlated with the SD of HbA1c levels (r = 0.73, p < 0.001) but not with HbA1c level. The levels of hs-CRP, TBARS, 8-OHdG, and 8-iso-PGF2α were significantly correlated with MAGE (r = 0.54, p = 0.001; r = 0.82, p < 0.001; r = 0.70, p < 0.001; r = 0.60, p < 0.001) and the SD of HbA1c levels (r = 0.53, p = 0.001; r = 0.73, p < 0.001; r = 0.69, p < 0.001; r = 0.43, p = 0.01) but not with HbA1c level. Relationships between 8-iso-PGF2α and MAGE or the SD of HbA1c levels remained significant after adjusting for other markers of diabetic control (R(2) = 0.684, R(2) = 0.595, p < 0.001, respectively). Both acute and chronic blood glucose variability can induce oxidative stress and chronic inflammation.

Haemoglobin A1c variability as an independent correlate of atherosclerosis and cardiovascular disease in Chinese type 2 diabetes

“…The underlying mechanism is complicated and has not been fully understood. Chang et al 24 found that the level of oxidative stress marker, 8-iso-PGF2α was significantly correlated with HbA1c-SD, which partially described the detrimental effect of HbA1c variability. Also, the 'metabolic memory' phenomenon is among the possible mechanisms.…”

Impaired Fasting Glucose & 8-Iso-Prostaglandin F2α in Diabetes Disease Progression

“…These pathophysiological changes are in turn linked with lipid peroxidation, oxidative stress, and inflammation seen in IFG and diabetes [9]. Lipid peroxidation is most often measured using malondialdehyde (MDA) and 8-iso-prostaglandin F 2α (8-iso-PGF 2α ) [10][11][12]. Oxidative stress can be determined by GSH and 8-hydroxy-2-deoxyguanosine (8-OHdG) assays [13][14][15].…”

“…Progression of atherosclerosis in turn leads to an increase in 8-OHdG, interleukin-6 (IL-6), C-reactive protein (CRP), MDA and 8-iso-PGF2α [12,14,21].…”

Association between Initial Glycemic Variation and 3-Month Cardiovascular Mortality in Diabetic Patients with Acute Ischemic Stroke

“…Large vascular disease affects the aorta, coronary artery, cerebral artery, renal artery, and peripheral artery mainly, which is hard to ignore; many researchers have studied the effect of blood glucose fluctuation on the vascular complications of T2DM [3][4][5][6]. Quagliaro et al confirmed that the blood vessel endothelium was damaged greater by blood glucose fluctuation than by chronic persistent hyperglycemia [6]; recent studies have demonstrated that acute and chronic fluctuations in blood glucose levels can increase oxidative stress in type 2 diabetes mellitus patients [7], which results in cell dysfunction and tissue injury [8]. Therefore, it is important to evaluate the relationship between the blood glucose fluctuation and the coronary artery disease by dynamic glucose monitoring.…”