The effect of glucose variability on the risk of microvascular complications in type 1 diabetes
The effect of glucose variability on the risk of microvascular complications in type 1 diabetes
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DOI：
10.2337/dc06-0293
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发表时间：
2006-07-01
期刊：
影响因子：
16.2
通讯作者：
Atkin, Stephen L.
中科院分区：
文献类型：
--
作者：
Kilpatrick, Eric S.;Rigby, Alan S.;Atkin, Stephen L.
目的-目前尚不清楚血糖不稳定是否会导致微血管并发症的风险，这是除了预测的平均血糖（MBG）值单独。本研究分析了糖尿病控制和并发症试验（DCCT）的数据，以评估葡萄糖变异性对I型糖尿病患者视网膜病变和肾病风险的影响。研究设计和方法-在DCCT期间每季度收集1,441例患者的餐前和餐后7点血糖曲线。将24小时内和两次访视之间的平均血糖曲线下面积和血糖变异性SD与视网膜病变和肾病风险进行比较，调整了年龄、性别、疾病持续时间、治疗组、预防队列，结果-多变量考克斯回归分析显示，日内和日间血糖在患者平均值附近的日变化对视网膜病变的发生或进展没有影响（分别为P = 0.18和P = 0.72）或肾病（P = 0.32和P = 0.57）。餐前（P = 0.18）或餐后（P = 0.31）的葡萄糖浓度优先贡献的概率retinopathy.CONCLUSIONS -这项研究表明，血糖的变异性似乎并不是一个额外的因素，在微血管并发症的发展。此外，餐前和餐后血糖值同样可以预测I型糖尿病的小血管并发症。
OBJECTIVE - it is not known whether glycemic instability may confer a risk of microvascular complications that is in addition to that predicted by the mean blood glucose (MBG) value alone. This study has analyzed data from the Diabetes Control and Complications Trial (DCCT) to assess the effect of glucose variability on the risk of retinopathy and nephropathy in patients with type I diabetes.RESEARCH DESIGN AND METHODS - Pre- and postprandial seven-point glucose profiles were collected quarterly during the DCCT in 1,441 individuals. The mean area under the curve glucose and the SD of glucose variability within 24 h and between visits were compared with the risk of retinopathy and nephropathy, having adjusted for age, sex, disease duration, treatment group, prevention cohort, and phase of treatment.RESULTS - Multivariate Cox regression showed that within-day and between-day variability in blood glucose around a patient's mean value has no influence on the development or progression of either retinopathy (P = 0.18 and P = 0.72, respectively) or nephropathy (P = 0.32 and P = 0.57). Neither preprandial (P = 0.18) nor postprandial (P = 0.31) glucose concentrations preferentially contribute to the probability of retinopathy.CONCLUSIONS - This study has shown that blood glucose variability does not appear to be an additional factor in the development of microvascular complications. Also, pre- and postprandial glucose values are equally predictive of the small-vessel complications of type I diabetes.