Objective To observe the effects of fluctuating hyperglycemia and persistent hyperglycemia on macrovascular and microvascular complications in patients with type 2 diabetes and explore the possible mechanisms.Methods A total of 112 patients with newly diagnosed type 2 diabetes mellitus who were hospitalized in the Affiliated Hospital of Xuzhou Medical University from November 2022 to May 2023 were selected and divided into two groups,52 patients in the persis-tent hyperglycemia group and 60 patients in the fluctuating hyperglycemia group according to the mean amplitude of glyce-mic excursions(MAGE).Macrovascular and microvascular complications were assessed.Results The fluctuating hy-perglycemia group had higher 2 h blood glucose,2 h insulin,carotid intima-media thickness(IMT)than the sustained hyperglycemia group(P＜0.05),while high-sensitivity C-reactive protein(hs-CRP),urinary albumin urine creatinine(UACR),brachial endothelium-dependent diastolic function(EDD),and ankle brachial index(ABI)were significantly lower(P＜0.05).Rates of coronary heart disease[30.0％(18 cases)vs.13.5％(7 cases),X2=4.394,P=0.036]and rates of cerebral infarction[26.7％(16 cases)vs.11.5％(6 cases),X2=4.039,P=0.044]increased,peripher-al arteriosclerosis worsened,and diabetic nephropathy[10.0％(6 cases)vs.25.0％(13 cases),X2=4.450,P=0.035]and diabetic retinopathy[8.3％(5 cases)vs.23.1％(12 cases),X2=4.703,P=0.030]decreased.Multi-variate logistic regression analysis showed that the influencing factors of macrovascular complications were 2 h blood glu-cose,2 h insulin,MAGE＞3.9 mmol/L,and brachial EDD(P＜0.05).The contributing factors for microvascular com-plications were fasting glucose,glycated hemoglobin,MAGE≤3.9 mmol/L,and hs-CRP(P＜0.05).Conclusion Fluctuating hyperglycemia has a greater influence on macrovascular complications in patients with type 2 diabetes,possi-bly due to impaired endothelial function,whereas sustained hyperglycemia has a stronger impact on microvascular compli-cations,which could be linked to inflammatory responses.
Type 2 diabetes mellitusFluctuating hyperglycemiaEndothelial functionAtherosclerosisInflam-matory response
维普
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