Relationships Among Long-Term Blood Glucose And Blood Pressure Fluctuation And Complications

Objectives: We investigated the relationships among long-term blood glucose and blood pressure fluctuation and micro-/macrovascular complications. Methods: We enrolled 156 patients with type 2 diabetes (84 men, age 67 ± 11 years old, HbA1c 7.0 ± 0.9%, GA 18.2 ± 3.8%) who underwent continuous glucose monitoring (CGM) at outpatient setting. Daily glycemic variability (mean amplitude of glycemic excursion; MAGE) was calculated from the CGM data. Coefficient of variation (CV) of HbA1c and GA were calculated from HbA1c and GA measured before and after 3 years from the time of CGM measurement. We analyzed the relationships among daily glycemic variability and long-term blood glucose fluctuation and their relation with blood pressure index, retinopathy stage, nephropathy stage, macrovascular complication (stroke, coronary artery disease and peripheral artery disease). Results: There was a weak correlation between daily glycemic variability and CV-HbA1c (r = 0.096, p = 0.23). CV-HbA1c was significantly correlated with HbA1c levels and BMI, respectively (r = 0.319, p < 0.01/ r = 0.316, p < 0.01). On the other hand, CV-SBP was significantly correlated with age (r = 0.213, p < 0.01). CV-HbA1c was associated with the presence of retinopathy and nephropathy, while CV-BP was not. There was no significant correlation between CV-HbA1c and CV-SBP and DBP (r = −0.012, p = 0.83/ r = 0.014, P = 0.86). Conclusion: Although both long-term blood pressure and blood glucose fluctuation appear to increase the risk of complications in patients with T2DM, there was no significant correlation between the two indices. It is suggested that the long-term blood pressure and blood glucose fluctuations independently and synergistically influence the development of diabetic complications.