ASSESSMENT OF GLYCEMIC VARIABILITY AND OXIDATIVE STRESS IN TYPE 2 DIABETIC PATIENTS USING CONTINUOUS GLUCOSE MONITORING

• KAINAT BAKHTIAR

  Author

• MUHAMMAD ARHAM RAUF

  Author

• MUHAMMAD MOHID MAQSOOD

  Author

• MALIK FARAZ AHMAD

  Author

Background: Glycemic variability (GV) has emerged as an important metabolic parameter contributing to oxidative stress and the development of diabetic complications. Unlike glycated hemoglobin (HbA1c), which reflects mean glycemia, GV represents short-term glucose fluctuations that may exert greater oxidative injury.

Objective: This study aimed to assess the relationship between glycemic variability indices derived from continuous glucose monitoring (CGM) and oxidative stress biomarkers in patients with type 2 diabetes mellitus (T2DM).

Methods: A cross-sectional observational study was conducted from January 2024 to January 2025 at tertiary care centers in Punjab, Pakistan. One hundred T2DM patients aged 35–65 years were monitored using a Freestyle Libre Pro CGM device for 14 days. Glycemic indices including Mean Amplitude of Glycemic Excursion (MAGE), Standard Deviation (SD), and Coefficient of Variation (CV) were calculated. Serum malondialdehyde (MDA) and total antioxidant capacity (TAC) were analyzed to assess oxidative stress. Statistical analysis was performed using SPSS v26 with p < 0.05 considered significant.

Results: The mean MAGE was 67.4 ± 17.9 mg/dL, MDA was 4.7 ± 0.8 µmol/L, and TAC was 1.12 ± 0.21 mmol/L. Patients in the highest MAGE tertile exhibited significantly elevated MDA and reduced TAC compared to those in the lowest tertile (p < 0.001). MAGE showed a positive correlation with MDA (r = 0.64, p < 0.001) and a negative correlation with TAC (r = –0.59, p < 0.001).

Conclusion: Increased glycemic variability is strongly associated with elevated oxidative stress in T2DM, independent of HbA1c. CGM-based monitoring may serve as a valuable tool to identify high-risk patients and guide interventions aimed at reducing glucose fluctuations.

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Copyright (c) 2025 KAINAT BAKHTIAR, MUHAMMAD ARHAM RAUF, MUHAMMAD MOHID MAQSOOD, MALIK FARAZ AHMAD (Author)

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