Relationships Between Glucose Fluctuations And Oxidative Stress In Short Duration Type 2 Diabetes Treated With Sensor-Augmented Insulin Pump

This study aims to explore the relationships between oxidative stress and glucose fluctuations in patients with short duration type 2 diabetes treated with sensor-augmented insulin pump (SAP). Sixty type 2 diabetes patients with duration < 1 year and HbA1c >= 9% were enrolled and randomly divided into the SAP group or the multiple daily injection (MDI) group, and all of them were performed 6-day enhanced treatments. Furthermore, the patients were also assigned to the severe oxidative group (group SO) or the weak oxidative group (group WO) according to median level of 8-iso-prostaglandin F2a (8-iso-PGF2a), an oxidative stress parameter. Compared with the baseline, the following parameters which indicate glucose fluctuations: the mean blood glucose (MBG), mean amplitude of glycemic excursion (MAGE), absolute mean of daily differences (MODD) and incremental area under the curve (IAUC) in group SAP were significantly decreased after 6-day therapy (P < 0.05), while no difference was found on terms of serum 8-iso-PGF2a levels (P > 0.05). After SAP therapy, the levels of MBG, MAGE, MODD and IAUC in group SAP were significantly lower than group MDI (P < 0.05). There was no difference in serum 8-iso-PGF2a levels and insulin daily dosage (IDD) between the groups (P > 0.05). The values of IDD and waistline in group SO were significantly higher than group WO (P < 0.05). The multiple regression analysis showed IDD (t=2.146, P=0.035) and waistline (t=4.502, P=0.011) were independently correlated with 8-iso-PGF2a. No relationship was found between oxidative stress and glucose fluctuations in short duration type 2 diabetes patients under the condition of short-term intensive SAP therapy, IDD and waistline were independent risk factors toward the activation of oxidative stress.