Glycemic variability evaluated by continuous glucose monitoring system is associated with the 10-y cardiovascular risk of diabetic patients with well-controlled HbA1c

Background: The present study aimed to identify the relationship between glycemic variability (GV) and the 10-y risk of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients with good glycemic control. Methods: Two-hundred forty consecutive T2DM patients (HbA1c <= 7.0%) without CVD were included to calculate the 10-y CVD risk by Framingham risk score (FRS), and divided into 3 groups: low-risk group (FRS <= 10%), intermediate-risk group (>10%, <= 20%) and high-risk group (>20%). Inter-group differences of GV were determined by comparing the SD of blood glucose (SDBG), mean amplitudes of glycemic excursion (MACE), and mean of daily differences (MODD) gathered from 72-h continuous glucose monitoring system. Results: The levels of SDBG and MAGE significantly increased along with the raises of 10-y CVD risk of T2DM patients (p < 0.01). FRS was positively correlated with age, systolic blood pressure, SDBG and MAGE (r = 0.717, 0.525, 0.509 and 0.485 respectively, p < 0.01), while negatively correlated with the level of HDL-C (r = -0.348, p < 0.01). Furthermore, multivariate logistic regression analysis confirmed that increased MACE [OR: 1.623(1.198-2.316), p < 0.001] and patients with high urine albumin excretion rates [OR: 1.743(1.247-2.793), p < 0.001] were independent predictors for high 10-y CVD risk. Conclusion: GV predicts independently the 10-y CVD risk of T2DM patients with well-controlled HbA1c. (C) 2016 Elsevier B.V. All rights reserved.