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Oxidative Stress Implicated in Glycemic Fluctuations

Activation of oxidative stress by hyperglycemia is suspected as a mechanism involved in the vascular dysfunction that is common in diabetes. In a study of 21 patients with type 2 diabetes, researchers measured oxidative stress over 24 hours based on urinary excretion of metabolites and used a continuous glucose monitoring system to measure glycemic excursions. Other assessment tests included measurement of glycated hemoglobin (A1C). The participants were studied over 3 continuous days.

Researchers report that glucose fluctuations during postprandial periods seemed to have a "more specific triggering effect on oxidative stress than chronic sustained hyperglycemia."

"The present data suggest that interventional trials in type 2 diabetes should target not only [A1C] and mean glucose concentrations but also acute glucose swings," the report concludes.

Monnier L, Mas E, Ginet C, et al.: Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA 295: 1681–1687, 2006[Abstract/Free Full Text] .

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