Endocrine Abstracts

Objective

To identify risk factors affecting the severity of glycemic variability indicators in patients with diabetes mellitus type 2.

Materials and methods

The study included 92 patients with diabetes mellitus type 2 and an average age of 62.25 ± 9.52 years. A biochemical blood test was performed on an automated Cobas 6000 system. To assess the glycemic variability, the standard deviation (SD, mmol/l), the coefficient of variation (CV, %) and the mean amplitude of glycemic excursion (MAGE, mmol/l) were determined. Statistical processing of the data array was performed using the statistical program MedCalc v.11.6.0.0. (MedCalc Software Inc.). The level P < 0.05 is considered as a criterion for the statistical confidence of the results.

Results

According to the results of logistic regression, BMI has a greater effect on CV (RR = 0.83; 95% CI 0.75–0.32 P = 0.002), SD (RR = 0.90; 95% CI 0.83–0.97, P = 0.009), MAGE (RR = 0.89; 95% CI 0.81–0.97, P = 0.014) than the experience of type 2 diabetes mellitus on CV (RR = 1.10; 95% CI 0, 99–1.21 P = 0.053), SD (RR = 1.09; 95% CI 0.99–1.19, P = 0.05), MAGE (RR = 1.06; 95% CI 0, 97–1.16, P = 0.136) and the level of TG on CV (RR = 0.53; 95% CI 0.27–1.05 P = 0.070), SD (RR = 0.80; 95% CI 0, 57–1.10, P = 0.176), MAGE (RR = 0.83; 95% CI 0.57–1.20, P = 0.335). A decrease in BMI increases the degree of manifestation of GV indicators by an average of 1.1 times. The threshold value of BMI was 28.6 kg/m² for CV AUC = 0.77 (sensitivity 64.0% [95% CI 42.5; 82.0], specificity 88.0% [95% CI 77.8; 94.7], P = 0.002), for SD AUC = 0.69 (sensitivity 41.67% [95% CI 27.6; 56.8], specificity 90.9% [95% CI 78.3; 97.5], P = 0.0003), for MAGE AUC = 0.68 (sensitivity 46.8% [95% CI 29.1; 65.3], specificity 86.4% [95% CI 75, 0; 94.0], P = 0.0021).

Conclusions

A risk factor that increases glycemic variability is a BMI less than 28.6 kg/m². A decrease in BMI increases the degree of manifestation of GV indicators by an average of 1.1 times.