Correlates of the Diurnal Plasma Glucose Variability in Non-insulin-treated Type 2 Diabetic Patients

The aim of the study was to identify clinical and biochemical factors modulating glycemic variability in type 2 diabetes (T2DM). We investigated 402 non-insulin-treated T2DM patients (210M/192F), age 57.9±11.2 years, 28 patients on diet only, 168 on monotherapy, 206 on combination therapy. Three daily venous plasma glucose profiles (pre-prandial and postprandial at breakfast, lunch and dinner), HbA1c, fasting total and HDL cholesterol, triglycerides and uric acid levels were obtained. Glycemic variability was evaluated by the standard deviation (SD) and mean amplitude of glycemia excursions (MAGE). Mean postprandial glycemia correlated with age, duration of diabetes and HbA1c. Mean postprandial delta glucose correlated inversely with the total cholesterol, BMI and waist circumference. SD and MAGE correlated directly with the age of the patients and HbA1c, inversely with uric acid levels, but not with duration of diabetes, BMI, total cholesterol, HDLcholesterol and triglyceride levels. SD and MAGE were the highest in sulfonylurea-treated patients. Age, duration of diabetes, HbA1c and sulfonylurea therapy are possible determinants of larger plasma glucose fluctuations in T2DM. In contrast, obesity and high cholesterol are associated with lower postprandial excursions. Higher uric acid levels are associated with reduced plasma glucose variability.