Previous studies reported that oxidative stress was associated with glucose variability measured by continuous glucose monitoring (CGM) in T2DM. The use of CGM, however, remains limited at present. We investigated the relationship between glycemic markers and oxidative stress in type 2 diabetes mellitus (T2DM).
Oxidative stress, hemoglobin A1c (HbA1c), and glycated albumin (GA) and 1,5-anhydro-D-glucitol (1.5-AG) were measured in 234 patients with T2DM. The oxidative stress was estimated using the diacron-reactive oxygen metabolites (d-ROMs) test. The associations of d-ROMs with GA, 1.5-AG, blood glucose, lipid metabolism markers, blood pressure, and clinical factors were examined.
Fasting plasma glucose (FPG), HbA1c, GA, TG, and LDL-C were correlated with d-ROMs in all of the T2DM patients. HbA1c and TG were correlated with d-ROMs in T2DM patients with HbA1c < 8.0 %. FPG, HbA1c, and GA were correlated with d-ROMs in T2DM patients with HbA1c ≧ 8.0 %. An inverse correlation was found between 1.5-AG and d-ROMs in all of the patients and in patients with HbA1c < 8.0 %. The following factors were found to be independent of d-ROMs by stepwise multiple regression analysis: 1.5-AG, sex, GA, TG, and the use of metformin in all patients; 1.5-AG, sex, HbA1c, and the use of metformin in patients with HbA1c < 8.0 %; and GA, sex, and FPG in patients with HbA1c ≧ 8%.
Our data suggest that 1.5-AG reliably estimates oxidative stress in well-controlled T2DM and that GA reliably estimates oxidative stress in poorly controlled T2DM.