Author:
Shi Rui,Feng Lei,Liu Yan-Mei,Xu Wen-Bo,Luo Bei-Bei,Tang Ling-Tong,Bi Qian-Ye,Cao Hui-Ying
Abstract
Abstract
Objective
For patients with diabetes, high-frequency and -amplitude glycemic variability may be more harmful than continuous hyperglycemia; however, there is still a lack of screening indicators that can quickly and easily assess the level of glycemic variability. The aim of this study was to investigate whether the glycemic dispersion index is effective for screening high glycemic variability.
Methods
A total of 170 diabetes patients hospitalized in the Sixth Affiliated Hospital of Kunming Medical University were included in this study. After admission, the fasting plasma glucose, 2-hour postprandial plasma glucose, and glycosylated hemoglobin A1c were measured. The peripheral capillary blood glucose was measured seven times in 24 h, before and after each of three meals and before bedtime. The standard deviation of the seven peripheral blood glucose values was calculated, and a standard deviation of > 2.0 was used as the threshold of high glycemic variability. The glycemic dispersion index was calculated and its diagnostic efficacy for high glycemic variability was determined by the Mann–Whitney U test, receiver operating characteristic (ROC) curve and, Pearson correlation analysis.
Results
The glycemic dispersion index of patients with high glycemic variability was significantly higher than that of those with low glycemic variability (p < 0.01). The best cutoff value of the glycemic dispersion index for screening high glycemic variability was 4.21. The area under the curve (AUC) was 0.901 (95% CI: 0.856–0.945) and had a sensitivity of 0.781 and specificity of 0.905. It was correlated with the standard deviation of blood glucose values (r = 0.813, p < 0.01).
Conclusions
The glycemic dispersion index had good sensitivity and specificity for screening high glycemic variability. It was significantly associated with the standard deviation of blood glucose concentration and is simple and easy to calculate. It was an effective screening indicator of high glycemic variability.
Funder
National Natural Science Foundation of China
Special Fund for Training Leading Medical Talents in Yunnan Province
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology, Diabetes and Metabolism,Internal Medicine
Reference23 articles.
1. Li Y, Teng DI, Shi X, Qin G, Qin Y, Quan H, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the american Diabetes Association: national cross sectional study. BMJ. 2020;369:m997.
2. Zhang ZY, Miao LF, Qian LL, Wang N, Qi MM, Zhang YM, et al. Molecular mechanisms of glucose fluctuations on diabetic complications. Front Endocrinol (Lausanne). 2020;10:640.
3. Wu N, Shen H, Liu H, Wang Y, Bai Y, Han P, et al. Acute blood glucose fluctuation enhances rat aorta endothelial cell apoptosis, oxidative stress and pro-inflammatory cytokine expression in vivo. Cardiovasc Diabetol. 2016;15(1):1–13.
4. Valente T, Arbex AK. Glycemic variability, oxidative stress, and impact on complications related to type 2 diabetes mellitus. Curr Diabetes Rev. 2021;17(7):e071620183816.
5. Chinese Society of Endocrinology. Expert consensus on management of blood glucose fluctuation in patients with diabetes. Chin J Endocrinol Metab. 2017;33(8):633–6.
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