The сardiometabolic assessment of the glycemic variability in patients with diabetes mellitus: the role of the glucocardiomonitoring

Abstract

Aim To study quantitatively the two-way relationship between parameters of glycemic variability and development of cardiovascular events in patients with type 2 diabetes mellitus (DM) on chronic sulfonylurea (SM) therapy by synchronous, professional glucose and cardiac monitoring.Material and methods The study included 421 patients with type 2 DM on SM therapy. A 5-day synchronous glucose and cardiac monitoring was performed for these patients in a retrospective mode using an iPro2 (Medtronic, USA) continuous glycemia monitoring (CGM) system and Holter monitoring. Glycemic endpoints (CGM-parameters of glycemia variability and integral indexes) and cardiological endpoints (ventricular rhythm disorders (VRD), ST segment depression (dST), and corrected QT interval (QTc)) were evaluated.Results Clear correlations were found between the ST segment depression and the increase in TIR-HYPO index and the length of QTc. The strongest correlation was observed for VRD and the increase in TIR-HYPO. Moderate correlations were observed between VRD and the decrease in TIR-NORMO and between increased variabilities of glycemia (increases in SD and number of glycemia excursions >4 mmol/l/h) and integral indexes (mean CGM-level of glycemia and HbA1c). Elongation of the QTc interval was associated with increased TIR-HYPO, decrease in maximum glycemia, and development of dST.Conclusion The glucose and cardiac monitoring confirmed the close interrelation between the quality of glycemic control and cardiovascular disorders and should be recommended for a wider use in real-life clinical practice for determining the cardiometabolic status of patients and personalization of hypoglycemic therapy.