Acta Diabetologica

, Volume 49, Supplement 1, pp 171–177 | Cite as

Acute and chronic fluctuations in blood glucose levels can increase oxidative stress in type 2 diabetes mellitus

  • Chih-Min Chang
  • Ching-Jung HsiehEmail author
  • Ju-Chun Huang
  • I-Chin Huang
Original Article


In order to investigate whether short- or long-term glycemic fluctuations could induce oxidative stress and chronic inflammation, we evaluated the relationships between glycemic variability, oxidative stress markers, and high-sensitivity C-reactive protein (hs-CRP). We enrolled 34 patients with type 2 diabetes. As a measure of short-term glycemic variability, mean amplitude of glycemic excursions (MAGE) was computed from continuous glucose monitoring system data. For determining long-term glycemic variability, we calculated the standard deviation (SD) of hemoglobin A1c (HbA1c) levels measured over a 2-year period. Levels of oxidative stress markers: 8-iso-prostaglandin F2α (8-iso-PGF2α), thiobarbituric acid-reactive substance (TBARS), 8-hydroxydeoxyguanosine (8-OHdG), and hs-CRP were measured. MAGE was significantly correlated with the SD of HbA1c levels (r = 0.73, p < 0.001) but not with HbA1c level. The levels of hs-CRP, TBARS, 8-OHdG, and 8-iso-PGF2α were significantly correlated with MAGE (r = 0.54, p = 0.001; r = 0.82, p < 0.001; r = 0.70, p < 0.001; r = 0.60, p < 0.001) and the SD of HbA1c levels (r = 0.53, p = 0.001; r = 0.73, p < 0.001; r = 0.69, p < 0.001; r = 0.43, p = 0.01) but not with HbA1c level. Relationships between 8-iso-PGF2α and MAGE or the SD of HbA1c levels remained significant after adjusting for other markers of diabetic control (R 2 = 0.684, R 2 = 0.595, p < 0.001, respectively). Both acute and chronic blood glucose variability can induce oxidative stress and chronic inflammation.


Blood glucose fluctuations Mean amplitude of glycemic excursions Oxidative stress 8-iso-prostaglandin F2α 



This work was supported by a research grant (CMRPG890481) from the Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan. No potential conflicts of interest relevant to this article were reported. The patients enrolled in this study were under the care of Ching Jung Hsieh and Ju-Chun Huang and. I-Chin Huang. Ching Jung Hsieh performed the data analysis and literature survey. Chih-Min Chang and Ching Jung Hsieh wrote the manuscript.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Chih-Min Chang
    • 1
  • Ching-Jung Hsieh
    • 1
    Email author
  • Ju-Chun Huang
    • 1
  • I-Chin Huang
    • 1
  1. 1.Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineNiao-Sung District, Kaohsiung CityTaiwan

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