Evaluation of the Glycemic Fluctuation as Defined as the Mean Amplitude of Glycemic Excursion in Hospitalized Patients with Type 2 Diabetes

Abstract

BACKGROUND In addition to hemoglobin Alc (HbAlc), fasting plasma glucose (FPG), and postprandial glucose (PPG) levels, it is recommended to take glycemic variability into consideration for an assessment of the glycemic control of patients with type 2 diabetes. The mean amplitude of glycemic excursion (MAGE) is proposed to be a more sensitive method than HbAlc in evaluation of the glycemic variability. The objective of this study was to determine the MAGE levels of patients with type 2 diabetes who were hospitalized for poor glycemic control and to investigate whether these levels showed differences according to the diabetes duration and treatment characteristics. MATERIAL and METHODS This study included a total of 50 patients with type 2 diabetes (39 female, 11 male; mean age: 59.54 +/- 11.96; mean diabetes duration: 12.1 years) who were hospitalized at Istanbul Medeniyet University Department of Internal Medicine for glycemic control. Capillary venous blood samples were collected from the patients 10 times a day for 2 days and the MAGE levels were determined. RESULTS The MAGE, HbAlc, fasting plasma glucose, and postprandial glucose levels of the patients were 85.18 +/- 21.64 mg/dL, 10.71 +/- 2.40%, 196.70 +/- 61.25 mg/dL, and 240.02 +/- 79.51 mg/dL, respectively. MAGE levels were found to be 93.93 +/- 19.85 mg/dL in patients who use insulin, 82.94 +/- 21.41 mg/dL in those who use oral antidiabetics (OAD), and 74.37 +/- 19.75 mg/dL in patients who use both insulin and OAD. MAGE levels were higher in the insulin-using patients compared to those using insulin and OAD together (p=0.002). CONCLUSION It was observed in the present study that MAGE levels were higher in type 2 diabetic patients with impaired glycemic control.