Glucose fluctuations and activation of oxidative stress in patients with type 1 diabetes

Diabetologia. 2008 Jan;51(1):183-90. doi: 10.1007/s00125-007-0842-6. Epub 2007 Nov 10.


Aims/hypothesis: Glucose fluctuations may help predict diabetic complications. We evaluated the relation between glucose variability and oxidative stress in patients with type 1 diabetes.

Methods: Continuous glucose monitors were inserted subcutaneously in 25 patients. During the measurement, patients collected two 24 h urine samples, while 24 healthy controls collected one 24 h urine sample for determination of 15(S)-8-iso-prostaglandin F2alpha(PGF2alpha) using HPLC tandem mass spectrometry. Mean of the daily differences (MODD), mean amplitude of glycaemic excursions (MAGE) and continuous overlapping net glycaemic action calculated with n hour time-intervals (CONGA-n) were calculated as markers for glucose variability and correlation with 15(S)-8-iso-PGF2alpha excretion was calculated.

Results: Median [interquartile range (IQR)] urinary 15(S)-8-iso-PGF2alpha was higher in patients than healthy controls: 161 (140-217) pg/mg creatinine vs 118 (101-146) pg/mg creatinine (p = 0.001). Median (IQR) MODD was 3.7 (3.2-5.0) mmol/l, MAGE 7.6 (6.4-9.0) mmol/l and CONGA-1 2.3 (2.1-2.8) mmol/l. Univariate regression did not reveal an association for MODD (r2 = 0.01), MAGE (0.08) or CONGA-1 (0.07) with 15(S)-8-iso-PGF2alpha excretion, nor was an association revealed when corrected for HbA1c, age, sex and smoking. Spearman correlation coefficients (r) between 15(S)-8-iso-PGF2alpha excretion and MODD, MAGE and CONGA-1 were non-significant: -0.112, -0.381 and -0.177.

Conclusions/interpretation: We report that there is no relationship between glucose variability and urinary 15(S)-8-iso-PGF2alpha. We also confirm that patients with type 1 diabetes have higher levels of urinary 15(S)-8-iso-PGF2alpha than healthy controls, suggesting that in addition to glucose variability, other factors favouring oxidative stress may exist. We did not see a relation between high glucose variability and elevated levels of oxidative stress in patients with type 1 diabetes.

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Case-Control Studies
  • Chromatography, High Pressure Liquid / methods
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / metabolism
  • Dinoprost / analogs & derivatives
  • Dinoprost / metabolism
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Biological
  • Oxidative Stress*
  • Sex Factors
  • Time Factors
  • Treatment Outcome


  • Blood Glucose
  • 8-epi-prostaglandin F2alpha
  • Dinoprost