Blood glucose fluctuation aggravates lower extremity vascular disease in type 2 diabetes.

OBJECTIVES Lower-extremity vascular diseases are important complication of diabetes. In the present study, we investigated the influence of blood glucose fluctuation in type 2 diabetes-associated lower-extremity vascular diseases, and explore the possible mechanism. PATIENTS AND METHODS Patients with type 2 diabetes was assigned to Group B (without lower-extremity vascular disease) and group C (with lower-extremity vascular disease). Healthy subjects (Group A) served as normal controls. All patients received dynamic blood glucose monitoring for 72 h. The mean amplitude of glycemic excursion (MAGE) and the largest amplitude of glycemic excursion (LAGE) were estimated. The levels of von Willebrand factor (vWF), ischemia-modified albumin (IMA), glycosylated hemoglobin (HbA1c), and biochemical indices were examined, and the lower-extremity vascular diseases were scored in patients from group C. RESULTS Groups B and C have higher systolic blood pressure (SBP), total cholesterol (TC) level, high-density lipoprotein cholesterol (HDL-C) level, HbA1c level, and vWF level and lower IMA level than those in Group A (p < 0.05). Elevated MAGE and LAGE were observed in groups B and C as compared with Group A. Correlation analysis revealed that the score of lower-extremity vascular diseases was associated with MAGE, LAGE, SBP, LDL-C, vWF, HbA1c, and IMA (p < 0.05). Stepwise multiple-linear regression analysis revealed that lower-extremity vascular diseases were involved with MAGE, IMA, and vWF. CONCLUSIONS Enhanced fluctuation in patients with type 2 diabetes may promote the occurrence and development of lower-extremity vascular diseases through aggravating vascular endothelial injury.