Glycemic Variability and Changes in Serum Lipid Profiles During Intensive Diabetes Management
DOI:
https://doi.org/10.61336/jdme.0402.05Keywords:
Glycemic variability, type 2 diabetes mellitus, lipid profile, continuous glucose monitoring, triglycerides, LDL cholesterol, diabetes management, metabolic controlAbstract
Glycemic variability represents fluctuations in blood glucose occurring throughout the day and may contribute to metabolic and vascular abnormalities beyond average glycemic exposure. The relationship between glycemic variability and serum lipid profiles during intensive diabetes management remains incompletely characterized. This study evaluated changes in glycemic variability and serum lipid parameters during a period of intensified diabetes management. A prospective observational study was conducted among 156 adults with type 2 diabetes mellitus who underwent treatment intensification and continuous glucose monitoring for 12 weeks. Glycemic variability was assessed using mean amplitude of glycemic excursions, coefficient of variation, and standard deviation of glucose, while serum total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, non-HDL cholesterol, and apolipoprotein B were measured at baseline and after 12 weeks. Participants demonstrated significant reductions in HbA1c, mean glucose, glucose coefficient of variation, and mean amplitude of glycemic excursions following treatment intensification. Reductions in triglycerides, non-HDL cholesterol, and apolipoprotein B were also observed, while HDL cholesterol increased modestly. Greater reductions in glycemic variability were associated with greater reductions in triglyceride and non-HDL cholesterol concentrations. After adjustment for age, sex, baseline lipid concentrations, BMI, diabetes duration, and change in body weight, the reduction in glucose coefficient of variation remained independently associated with improvement in triglyceride concentration. Participants achieving both improved glycemic variability and HbA1c reduction demonstrated a more favorable lipid profile than those achieving improvement in HbA1c without substantial reduction in glycemic variability. These findings suggest that improvement in daily glucose fluctuations during intensive diabetes management may be accompanied by favorable changes in circulating lipid parameters.
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