Oxidative Stress Implicated in Glycemic Fluctuations

Studies of oxidative stress suggest that acute glucose fluctuations may contribute more than sustained chronic hyperglycemia to accelerated atherosclerosis and other cardiovascular complications of type 2 diabetes, according to a report published in JAMA by a group of researchers at the University of Montpelier in France.

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.▪

.