Glycemic variability indices determined by self-monitoring of blood glucose are associated with ß-cell function in Chinese patients with type 2 diabetes.

ABSTRACT

INTRODUCTION: Glycemic control plays an important role in diabetes management, and self-monitoring of blood glucose (SMBG) is critical to achieving good glycemic control. However, there are few studies about the relationship between SMBG-estimated glycemic indices and ß-cell function. Here we investigated the association between glucose variation indices estimated by SMBG and ß-cell function among Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: In this cross­sectional study, 397 patients with T2DM were recruited from February 2015 to October 2016. ß-cell function was monitored using the Homeostasis Model Assessment 2 (HOMA2)-%ß index. The parameters evaluated by SMBG were the mean blood glucose (MBG), standard deviation of MBG (SDBG), largest amplitude of glycemic excursions (LAGE), and postprandial glucose excursion (PPGE). RESULTS: HOMA2-%ß was negatively correlated with SDBG, LAGE, PPGE, and MBG (r = -0.350, -0.346, -0.178, and -0.631, respectively; all p < 0.01). After adjusting for confounding characteristics (diabetic duration, triglyceride, total cholesterol, fasting C-peptide, HOMA2-insulin resistance index, hypoglycemia, and diabetic treatments) and glycated hemoglobin A1c on a continuous scale, odds ratios of SDBG, LAGE, PPGE, and MBG between the patients in the lowest and highest HOMA2-%ß quartiles were 2.02 (1.14-3.57), 1.24 (1.04-1.49), 1.13 (0.86-1.51), and 2.26 (1.70-3.00). HOMA2-%ß was independently associated with SDBG, LAGE, and MBG. CONCLUSIONS: Increased SDBG and LAGE assessed by SMBG are associated with ß-cell dysfunction in Chinese patients with T2DM.