Relationship between daily and day-to-day glycemic variability and increased oxidative stress in type 2 diabetes

Diabetes Res Clin Pract. 2016 Dec;122:62-70. doi: 10.1016/j.diabres.2016.09.025. Epub 2016 Oct 14.


Aims: To determine the association of daily and day-to-day glucose variability with oxidative stress.

Methods: This was a cross-sectional analysis of 68 patients with type 2 diabetes mellitus (T2DM) over 72h of continuous glucose monitoring. Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) were measured before breakfast on day 1. Glucose variability, mean glucose level (MGL), mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD) in glucose levels and area under the postprandial plasma glucose curve (AUCPP) were measured on days 2 and 3. Plasma oxidant capacity against N,N-diethylparaphenylenediamine was measured with the diacron-reactive oxygen metabolites (d-ROMs) test on day 1.

Results: Overall, 66.2% males with the mean age of 63.2±12.6years, diabetes duration of 12.9±10.4years, and HbA1c level of 8.1±1.6% (65±17mmol/mol) were included. MGL (r=0.330), HbA1c (r=0.326), MAGE (r=0.565), MODD (r=0.488), and AUCPP (r=0.254) exhibited significant correlations with d-ROMs and not FPG; these correlations remained significant after adjustment for clinical factors (sex, age, duration of diabetes, smoking habit, insulin use, statin use, angiotensin II receptor blocker use, BMI, LDL-C, HDL-C, TG, eGFR, and systolic blood pressure) (R2=0.268, R2=0.268, R2=0.417, R2=0.314, and R2=0.347, respectively). MAGE was significantly correlated with MODD (r=0.708) and MAGE and MODD were independently correlated with d-ROMs by multivariate analysis.

Conclusions: Therefore, oxidative stress is associated with daily and day-to-day glucose variability in patients with T2DM.

Keywords: Diacron-reactive oxygen metabolites; Glucose monitoring; Glucose variability; Oxidative stress; Type 2 diabetes mellitus.

MeSH terms

  • Aged
  • Area Under Curve
  • Blood Glucose / metabolism*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Glycemic Index*
  • Humans
  • Male
  • Middle Aged
  • Oxidative Stress / physiology*
  • Reactive Oxygen Species / metabolism*


  • Blood Glucose
  • Glycated Hemoglobin A
  • Reactive Oxygen Species
  • hemoglobin A1c protein, human