Fig. 1Diagram of schedule for 7-point self-monitoring of blood glucose (SMBG) and glycated hemoglobin (HbA1c) measurements.
Fig. 2Differences in standard deviation (A) and mean absolute glucose change (B) grouped according to the use of individual oral hypoglycemic agents. SU, sulfonylurea; DPP4i, dipeptidyl peptidase-4 inhibitor; AGI, α-glucosidase inhibitor; MET, metformin; TZD, thiazolidinedione. aP<0.05 by Student t test.
Fig. 3Differences in standard deviation (A) and mean absolute glucose change (B) according to oral hypoglycemic agent groups. Group 1: dipeptidyl peptidase-4 inhibitor (DPP4i) or α-glucosidase inhibitor (AGI)-use/sulfonylurea (SU)-non-use; group 2: DPP4i or AGI-non-use/SU-non-use; group 3: DPP4i or AGI-use/SU-use; and group 4: DPP4i or AGI-non-use/SU-use. On grouping, the administration of thiazolidinedione and metformin was not considered. ANOVA, analysis of variance.
Fig. 4Differences in standard deviation (A) and mean absolute glucose change (B) according to quartiles of 10-year atherosclerotic cardiovascular disease (ASCVD) risk. Quartiles of 10-year ASCVD risk: first quartile range ≤7.9%, second quartile range 8% to 13.9%, third quartile range 14% to 23.9%, and fourth quartile range ≥24%. ANOVA, analysis of variance.
Table 1Patients' Clinical and Laboratory Characteristics
Characteristic |
Value |
Number |
209 |
Male sex, % |
69.9 |
Age, yr |
58.3±0.6 |
Body mass index, kg/m2
|
26.1±0.2 |
Waist circumference, cm |
90.0±0.6 |
Systolic blood pressure, mm Hg |
138.0±1.2 |
Duration of diabetes, yr |
7.8±0.5 |
C-peptide, nmol/L |
0.75±0.02 |
HbA1c, mmol/mol |
53.0±0.6 |
HbA1c, % |
7.0±0.1 |
AST, IU/L |
26.2±0.8 |
ALT, IU/L |
31.4±1.3 |
hsCRP, mmol/L |
14.3±1.9 |
Uric acid, µmol/L |
310.0±5.1 |
eGFR, mL/min/1.73 m2
|
72.9±0.8 |
UACR, mg/g |
156.3±26.5 |
ABI |
1.2±0.1 |
Total cholesterol, mmol/L |
4.48±0.06 |
Triglyceride, mmol/L |
1.48±0.06 |
HDL-C, mmol/L |
1.24±0.02 |
LDL-C, mmol/L |
2.73±0.06 |
Standard deviation |
2.23±0.06 |
MAG, mmol/L/hr |
1.17±0.03 |
Use of SU, % |
59.3 |
Use of MET, % |
81.8 |
Use of TZD, % |
8.1 |
Use of DPP4i, % |
12.9 |
Use of AGI, % |
5.7 |
Frequency of hypoglycemia |
0.16±0.04 |
10-Year ASCVD risk, % |
17.1±0.8 |
Table 2Pearson's Correlational Analysis of the Relationships between Indices of Glycemic Variability and Cardiovascular Risk Factors
Variable |
Standard deviation |
Mean absolute glucose change |
ra
|
P value |
ra
|
P value |
HbA1c, mmol/mol |
0.333 |
<0.001 |
0.230 |
<0.001 |
Duration of diabetes, yr |
0.238 |
<0.001 |
0.158 |
0.025 |
Frequency of hypoglycemia |
0.166 |
0.016 |
0.137 |
0.051 |
C-peptide, nmol/L |
0.161 |
0.020 |
0.186 |
0.008 |
UACR, mg/g |
0.123 |
0.078 |
-0.030 |
0.676 |
Waist circumference, cm |
0.078 |
0.265 |
0.102 |
0.149 |
Body mass index, kg/m2
|
0.057 |
0.410 |
0.050 |
0.483 |
Triglyceride, mmol/L |
0.098 |
0.159 |
0.126 |
0.074 |
hsCRP, mmol/L |
-0.060 |
0.392 |
-0.074 |
0.291 |
HDL-C, mmol/L |
-0.041 |
0.559 |
-0.064 |
0.363 |
LDL-C, mmol/L |
-0.077 |
0.266 |
-0.027 |
0.699 |
Uric acid, µmol/L |
-0.089 |
0.201 |
0.008 |
0.915 |
eGFR, mL/min/1.73 m2
|
0.023 |
0.737 |
0.000 |
0.995 |
ABI |
0.025 |
0.721 |
0.031 |
0.664 |
Table 3Differences in Glycemic Variability Indices according to the Regimen of Antidiabetic Agents
Variable |
SD, mmol/L |
MAG, mmol/L/hr |
Drug naïve (n=18) |
1.775 (1.389-2.023)a
|
0.920 (0.674-1.119)a
|
Mono-therapy (n=50) |
|
|
MET (n=39) |
1.624 (1.452-2.328)a
|
0.863 (0.669-1.277)a
|
SU (n=11) |
2.260 (1.925-3.263) |
1.122 (0.955-1.833) |
Dual-therapy (n=122) |
|
|
MET+DPP4i (n=25) |
1.658 (1.352-2.267)a
|
0.824 (0.693-1.168)a
|
MET+SU (n=85) |
2.547 (2.140-3.158) |
1.301 (1.098-1.660) |
Triple-therapy (n=19) |
|
|
MET+SU+AGI (n=9) |
1.621 (1.157-2.886)a
|
0.726 (0.525-1.368)a
|
MET+SU+TZD (n=9) |
2.168 (2.037-2.449) |
1.307 (1.095-1.588) |
Table 4Hierarchical Multiple Regression Analysis between Indices of Glycemic Variability and Other Variables
Variable |
Standard deviation |
Mean absolute glucose change |
Model 1 (R2 =0.185) |
Model 2 (R2 =0.242) |
Model 3 (R2 =0.235) |
Model 1 (R2 =0.116) |
Model 2 (R2 =0.195) |
Model 3 (R2 =0.179) |
β |
P value |
β |
P value |
β |
P value |
β |
P value |
β |
P value |
β |
P value |
Age, yr |
0.040 |
0.540 |
0.068 |
0.290 |
0.057 |
0.400 |
0.024 |
0.731 |
0.057 |
0.405 |
0.060 |
0.403 |
Male sex |
0.031 |
0.639 |
0.004 |
0.950 |
0.005 |
0.946 |
0.121 |
0.086 |
0.083 |
0.225 |
0.100 |
0.181 |
HbA1c, mmol/mol |
0.325 |
<0.001 |
0.288 |
<0.001 |
0.264 |
<0.001 |
0.236 |
0.001 |
0.192 |
0.007 |
0.190 |
0.013 |
Duration of diabetes, yr |
0.152 |
0.024 |
0.088 |
0.209 |
0.107 |
0.158 |
0.100 |
0.161 |
0.026 |
0.722 |
0.072 |
0.366 |
Frequency of hypoglycemia |
0.233 |
<0.001 |
0.189 |
0.004 |
0.205 |
0.002 |
0.209 |
0.003 |
0.162 |
0.017 |
0.158 |
0.024 |
C-peptide, nmol/L |
0.151 |
0.024 |
0.087 |
0.193 |
0.106 |
0.174 |
0.160 |
0.024 |
0.093 |
0.183 |
0.109 |
0.183 |
Use of SUa
|
- |
- |
0.231 |
0.003 |
0.209 |
0.009 |
- |
- |
0.248 |
0.002 |
0.214 |
0.011 |
Use of DPP4ia
|
- |
- |
-0.096 |
0.168 |
-0.114 |
0.113 |
- |
- |
-0.135 |
0.066 |
-0.144 |
0.059 |
Use of AGIa
|
- |
- |
-0.142 |
0.024 |
-0.111 |
0.095 |
- |
- |
-0.144 |
0.030 |
-0.128 |
0.067 |
Use of METa
|
- |
- |
0.051 |
0.417 |
0.042 |
0.522 |
- |
- |
0.071 |
0.280 |
0.061 |
0.376 |
Use of TZDa
|
- |
- |
-0.050 |
0.443 |
-0.072 |
0.296 |
- |
- |
-0.037 |
0.581 |
-0.039 |
0.586 |
UACR, mg/g |
- |
- |
- |
- |
0.046 |
0.489 |
- |
- |
- |
- |
-0.085 |
0.229 |
Waist circumference, cm |
- |
- |
- |
- |
0.074 |
0.347 |
- |
- |
- |
- |
0.037 |
0.659 |
LDL-C, mmol/L |
- |
- |
- |
- |
-0.108 |
0.112 |
- |
- |
- |
- |
-0.074 |
0.295 |
HDL-C, mmol/L |
- |
- |
- |
- |
-0.009 |
0.903 |
- |
- |
- |
- |
0.024 |
0.747 |
Triglyceride, mmol/L |
- |
- |
- |
- |
-0.011 |
0.891 |
- |
- |
- |
- |
0.036 |
0.651 |
hsCRP, mmol/L |
- |
- |
- |
- |
-0.059 |
0.380 |
- |
- |
- |
- |
-0.083 |
0.243 |
Uric acid, µmol/L |
- |
- |
- |
- |
-0.059 |
0.435 |
- |
- |
- |
- |
0.020 |
0.799 |