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Serum bilirubin levels are positively associated with glycemic variability in women with type 2 diabetes.

ABSTRACT: AIMS/INTRODUCTION:Glycemic variability is known to induce oxidative stress. We investigated the relationships between glycemic variability and serum bilirubin levels, an endogenous anti-oxidant, in patients with diabetes. MATERIALS AND METHODS:A cross-sectional study was carried out with 77 patients with type 2 diabetes who had been recruited to two clinical studies from 2008 to 2014. There were no participants with diseases of the pancreas, liver, biliary tract and chronic renal insufficiency. Glycemic variation was calculated by a continuous glucose monitoring system, and correlation analyses were carried out to evaluate their association with bilirubin levels. Multiple linear regression was carried out to identify independent factors influencing bilirubin levels and glycemic variation. RESULTS:Among the participants, 42.3% were men. The mean (standard deviation) age was 61.5 years (10.4 years), body mass index was 24.2 kg/m2 (2.8 kg/m2 ), diabetes duration was 17.7 years (9.5 years), hemoglobin A1c was 60.7 mmol/mol (7.1 mmol/mol; 7.7 [0.7]%) and bilirubin was 11.8 ?mol/L (4.10 ?mol/L). Serum bilirubin levels were not different according to age, body mass index and hemoglobin A1c . However, the mean amplitude of glucose excursion was positively associated with bilirubin levels in women (r = 0.588, P < 0.001). After adjustment with duration of diabetes, serum albumin, liver enzymes, and mean glucose, the correlation between bilirubin and mean amplitude of glucose excursion remained significant (r = 0.566, P < 0.001). Multiple linear regression analyses showed that bilirubin was an independent determinant for the mean amplitude of glucose excursion in women. 1,5-Anhydroglucitol was also associated with bilirubin levels in women. CONCLUSIONS:Bilirubin level within the physiological range might be an independent predictor for glycemic variability in women with type 2 diabetes.

SUBMITTER: Kim LK

PROVIDER: S-EPMC5089950 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Serum bilirubin levels are positively associated with glycemic variability in women with type 2 diabetes.

Kim Lee Kyung LK Roh Eun E Kim Min Joo MJ Kim Min Kyeong MK Park Kyeong Seon KS Kwak Soo Heon SH Cho Young Min YM Park Kyong Soo KS Jang Hak Chul HC Jung Hye Seung HS

Journal of diabetes investigation 20160604 6

<h4>Aims/introduction</h4>Glycemic variability is known to induce oxidative stress. We investigated the relationships between glycemic variability and serum bilirubin levels, an endogenous anti-oxidant, in patients with diabetes.<h4>Materials and methods</h4>A cross-sectional study was carried out with 77 patients with type 2 diabetes who had been recruited to two clinical studies from 2008 to 2014. There were no participants with diseases of the pancreas, liver, biliary tract and chronic renal ...[more]

PMID: 27180936

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Project description:IntroductionPatients with type 2 diabetes (T2D) receiving premixed insulin often fail to achieve optimal glycemic control. The insulin injection technique (IT) itself may be one of the factors affecting glycemic variability (GV). The aim of this study was to assess the relationship between GV and IT in patients with T2D using premixed insulin.MethodsThis was a single center, cross-sectional, and self-controlled trial. Patients with T2D using premixed insulin were enrolled as inpatients. The 4-day study consisted of a 2-day patient insulin injection period (days 0 and 1) and a 2-day specialist nurse insulin injection period (days 2 and 3). Patient insulin IT were assessed on day 1 by two independent nurses using a skill-related scale consisting of 15 items, with a maximum score for each item of 2 and a total optimum score of 30. All patients underwent 96-h continuous glucose monitoring (CGM) during the 4-day study, and CGM data collected on days 1 and 3 were recorded and analyzed. The primary outcome was the relationship between the insulin IT score and the 24-h mean amplitude glycemic excursion (MAGE) during the patient injection period.ResultsA total of 52 inpatients with T2D who used premixed insulin were recruited and completed the study. The mean total insulin IT score of these patients was considerably lower than the optimum score (17.0 ± 4.4 vs. 30). Our CGM data showed that the MAGE was significantly higher during the patient injection period than during the nurse injection period (P < 0.05). Multiple linear stepwise regression analysis showed that the patient IT score was negatively correlated to the MAGE (P < 0.05). The patient IT score was also negatively correlated to glycated hemoglobin (HbA1c; P < 0.05).ConclusionsA poorer insulin IT may negatively affect GV and HbA1c control in patients with T2D using premixed insulin. Our data indicate that the insulin IT is important for short- and long-term glycemic control.Clinical trial registrationClinicalTrials.gov identification number: NCT03513055.

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Serum bilirubin levels are positively associated with glycemic variability in women with type 2 diabetes.

Publications

Serum bilirubin levels are positively associated with glycemic variability in women with type 2 diabetes.

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