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Glucose Variability Has No Cardio Protective Role

Modest decrease in intraday glucose variability does not affect secondary cardiovascular events

TUESDAY, April 12 (HealthDay News) -- Reduction in intraday glucose variability (GV) in treatment of patients with type 2 diabetes does not affect subsequent secondary cardiovascular events, according to a study published in the April issue of Diabetes Care.

Sarah E. Siegelaar, M.D., from the Academic Medical Centre in Amsterdam, Netherlands, and colleagues re-examined data from the Hyperglycemia and Its Effect After Acute Myocardial Infarction on Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus (HEART2D) study to assess the effect of GV on cardiovascular outcomes in patients with type 2 diabetes who had acute myocardial infarction (MI). A total of 1,115 patients were included in the study within 21 days after admission for an acute MI; 557 patients were randomized into a treatment group targeting postprandial hyperglycemia (PRANDIAL) and 558 patients into a group targeting fasting or interprandial hyperglycemia (BASAL). The mean amplitude of glycemic excursions, mean absolute glucose (MAG) change, and standard deviation were used to calculate GV.

The investigators found an 18 percent reduction in MAG with PRANDIAL strategy versus BASAL (mean [standard error of the mean] difference 0.09 [0.04] mmol/L/h). The mean amplitude of glycemic excursions and standard deviation in the PRANDIAL group were not significantly lower than in the BASAL group. The two groups had comparable hemoglobin A1c levels and cardiovascular event rates.

"The results of the present analysis showed that targeting postprandial glucose decreased intraday GV by 18 percent without a corresponding reduction in subsequent secondary cardiovascular events," the authors write.

Two authors disclosed financial relationships with Eli Lilly, which sponsored the HEART2D study.

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