Introduction & Objective: Persons with diabetes are prone to have atherosclerosis, stenosis, poor blood fluid properties, and other adverse blood vessel health conditions, leading to occurrence of stroke. Thus, this study aims to examine the effects of glycemic variability on brain imaging abnormalities in persons with type 2 diabetes (T2DM).
Methods: This study consisted of 2,536 persons with T2DM who underwent magnetic resonance imaging (MRI) of the brain after they attended the Diabetes Care Management Program of a medical center in Taichung from 2001-2015. After 1:1 age and sex matching, we identified 958 persons with or without white matter hyperintensity (WMH) and 1,106 persons with or without cerebrovascular abnormality (CA). Glycemic variability is estimated using the coefficient of variation in fasting plasma glucose (FPG-CV) within one year of index date (date of first MRI assessment). Logistic regression models were used to assess whether FPG-CV is associated with brain imaging abnormalities.
Results: FPG-CV was associated with CA in multivariable analysis (tertile 2 vs. 1: odds ratios [ORs] 1.48, 95% confidence intervals [95% CI] 1.20-1.83 for unmatched population and 1.35, 1.08-1.68 for matched population; tertile 3 vs. 1: 2.07, 1.65-2.60 for unmatched population and 1.83, 1.44-2.33 for matched population; both P for trend <0.001) but not with WMH.
Conclusion: Our finding indicated glycemic variability may be used as markers to predict cerebrovascular abnormality in persons with T2DM. In addition, glycemic management might guide clinicians toward specific strategies to prevent cerebrovascular abnormality in clinical practice.
T. Li: None. C. Lin: None. C. Li: None. C. Liu: None. C. Yang: None.
