Relationship between the Glucose Fluctuation with Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus Complicated with Acute Cerebral Infarction

Objective To investigate the relationship between the glucose fluctuation with carotid intima-media thickness( IMT) in patients with type 2 diabetes mellitus( T2DM) complicated with acute cerebral infarction( ACI).Methods A total of 50 patients with T2DM were divided into T2DM complicated with ACI( group A,n = 30) and only T2DM( group B,n = 20). All patients were monitored for 72 h with the continuous glucose monitoring system( CGMS),and levels of blood fat and glycated hemoglobin( HbA1c) were also detected at the same time. The IMT value was detected by high frequency of color ultrasonic Doppler. The patients in group A were divided into IMT normal group( IMT 0. 9 mm) and IMT thicking group( IMT≥0. 9 mm) according to IMT = 0. 9 of tangential point. The glucose fluctuation,blood fat,HbAlc and blood pressure level were compared in the four groups,and the correlations between IMT with the above values were also analyzed. Results The differences in mean amplitude of glycemic excursions( MAGE),IMT,blood pressure,low density lipoprotein( LDL),triglyceride( TG),total cholesterol( TC) and HbAlc between group A and B were statistically significant( P 0. 05); there were 13 patients with normal IMT and 17 with thicking IMT,and the differences in MAGE,systolic blood pressure( SBP),LDL and IMT between IMT normal group and IMT thicking group were statistically significant( P 0. 01). The correlation analysis showed that IMT was significantly correlated with MAGE,SBP and LDL( r = 0. 912,r = 0. 851,r = 0. 850,P 0. 01). The multiple stepwise regression analysis showed that the MAGE,LDL and SBP went into the final equation with IMT as the dependent variables and MAGE,blood fat,HbA1c,blood pressure and disease course as independent variables. Conclusion The blood glucose fluctuation in patients with T2DM complicated with ACI is significantly higher,and the atherosclerosis( AS) degree is more severe. So the glucose should be steadily reduced at the same time of high-performance reducing glucose in order to decrease the AS incidence and postpone cerebrovascular complications.