Impact of Glycemic and Blood Pressure Variability on Surrogate Measures of Cardiovascular Outcomes in Type 2 Diabetic Patients
Open accessAbstract
OBJECTIVE: The effect of glycemic variability (GV) on cardiovascular risk has not been fully clarified in type 2 diabetes. We evaluated the effect of GV, blood pressure (BP), and oxidative stress on intima-media thickness (IMT), left ventricular mass index (LVMI), flow-mediated dilation (FMD), and sympathovagal balance (low frequency [LF]/high frequency [HF] ratio) in 26 type 2 diabetic patients (diabetes duration 4.41 ± 4.81 years; HbA1c 6.70 ± 1.25%) receiving diet and/or metformin treatment, with no hypotensive treatment or complications. RESEARCH DESIGN AND METHODS: Continuous glucose monitoring (CGM) data were used to calculate mean amplitude of glycemic excursion (MAGE), continuous overall net glycemic action (CONGA)-2, mean blood glucose (MBG), mean postprandial glucose excursion (MPPGE), and incremental area under the curve (IAUC). Blood pressure (BP), circadian rhythm, and urinary 15-F2t-isoprostane (8-iso-prostaglandin F2α [PGF2α]) were also evaluated. Subjects were divided into dipper (D) and nondipper (ND) groups according to ΔBP. RESULTS: IMT and LVMI were increased in ND versus D (0.77 ± 0.08 vs. 0.68 ± 0.13 [P = 0.04] and 67 ± 14 vs. 55 ± 11 [P = 0.03], respectively). MBG, MAGE, and IAUC were significantly associated with LF/HF ratio at night (r = 0.50, P = 0.01; r = 0.40, P = 0.04; r = 0.41, P = 0.04, respectively), MPPGE was negatively associated with FMD (r = −0.45, P = 0.02), and CONGA-2 was positively associated with LVMI (r = 0.55, P = 0.006). The Δsystolic BP was negatively associated with IMT (r = −0.43, P = 0.03) and with LVMI (r = −0.52, P = 0.01). Urinary 8-iso-PGF2α was positively associated with LVMI (r = 0.68 P < 0.001). CONCLUSIONS: An impaired GV and BP variability is associated with endothelial and cardiovascular damage in short-term diabetic patients with optimal metabolic control. Oxidative stress is the only independent predictor of increased LV mass and correlates with glucose and BP variability.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Glycemic variability is associated with increased risk of cardiovascular disease in patients with type 2 diabetes.
“increased risk of cardiovascular disease18–20”
From Glycemic variability and cardiovascular disease in patients with type 2 diabetes (2021) · cites this paper as [18]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 27 · Cited by 179
- Authors
- Di Flaviani, A., Picconi, F., Di Stefano, P., Giordani, I., Malandrucco, I., Maggio, P., Palazzo, P., Sgreccia, F., Peraldo, C., Farina, F., Frajese, G., & Frontoni, S.
- Affiliations
- Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, University of Rome Tor Vergata, Rome, Italy
- University of Rome Tor Vergata (IT)
- Medtronic Italia S.p.A., Rome, Italy
- Fatebenefratelli Hospital (IT)
- Corresponding author
- Frontoni, Simona
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-06-17
- Volume
- 34
- Issue
- 7
- Pages
- 1605-1609
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3120198
- OpenAlex
- W2159086743
- Cited by
- 179
- References
- 27
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 11 · 2023: 15 · 2022: 4 · 2021: 20 · 2020: 13 · 2019: 8 · 2018: 17 · 2017: 12 · 2016: 12 · 2015: 12 · 2014: 19 · 2013: 13 · 2012: 9
- FWCI
- 11.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Funders
- Abbott Laboratories
- Australian Centre for Advanced Photovoltaics
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- glycemic variability, blood pressure variability, type 2 diabetes, cardiovascular risk, intima-media thickness, left ventricular mass, flow-mediated dilation, sympathovagal balance, oxidative stress, circadian blood pressure rhythm, mean amplitude of glycemic excursions, continuous glucose monitoring, metformin, postprandial glucose excursions
- MeSH terms
- Aged, Blood Glucose, Blood Pressure, Cardiovascular Diseases, Circadian Rhythm, Diabetes Mellitus, Type 2, Heart Ventricles, Humans, Middle Aged, Dinoprost, Treatment Outcome, Tunica Intima
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
