Glucose Fluctuation and Severe Internal Carotid Artery Siphon Stenosis in Type 2 Diabetes Patients

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  • Futoshi Eto
    Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Kazuo Washida
    Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Masaki Matsubara
    Division of Diabetes and Lipid Metabolism, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Hisashi Makino
    Division of Diabetes and Lipid Metabolism, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Akio Takahashi
    Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Kotaro Noda
    Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Yorito Hattori
    Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Yuriko Nakaoku
    Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Kunihiro Nishimura
    Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Kiminori Hosoda
    Division of Diabetes and Lipid Metabolism, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
  • Masafumi Ihara
    Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan

Description

<jats:p>The impact of glucose fluctuation on intracranial artery stenosis remains to be elucidated. This study aimed to investigate the association between glucose fluctuation and intracranial artery stenosis. This was a cross-sectional study of type 2 diabetes mellitus (T2DM) patients equipped with the FreeStyle Libre Pro continuous glucose monitoring system (Abbott Laboratories) between February 2019 and June 2020. Glucose fluctuation was evaluated according to the standard deviation (SD) of blood glucose, coefficient of variation (%CV), and mean amplitude of glycemic excursions (MAGE). Magnetic resonance angiography was used to evaluate the degree of intracranial artery stenosis. Of the 103 patients, 8 patients developed severe internal carotid artery (ICA) siphon stenosis (≥70%). SD, %CV, and MAGE were significantly higher in the severe stenosis group than in the non-severe stenosis group (<70%), whereas there was no significant intergroup difference in the mean blood glucose and HbA1c. Multivariable logistic regression analysis adjusted for sex showed that SD, %CV, and MAGE were independent factors associated with severe ICA siphon stenosis. In conclusion, glucose fluctuation is significantly associated with severe ICA siphon stenosis in T2DM patients. Thus, glucose fluctuation can be a target of preventive therapies for intracranial artery stenosis and ischemic stroke.</jats:p>

Journal

  • Nutrients

    Nutrients 13 (7), 2379-, 2021-07-12

    MDPI AG

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