Association of glycemic variability with oxidative stress and AGE accumulation in type 2 diabetes

Oxidative stress and advanced glycation end products (AGEs) could promote vascular aging in type 2 diabetes mellitus (T2DM), but their relationship with glycemic variability remains unclear. We conducted a cross-sectional study of 68 patients with T2DM who underwent continuous glucose monitoring (CGM). Short-, intermediate-, and long-term glycemic variability were assessed using the % coefficient of variation of glucose (%CV), mean of daily differences (MODD), and HbA1c variability over the prior 2 years, respectively. Oxidative stress was measured by the diacron-reactive oxygen metabolites (d-ROMs) test, and AGE accumulation by skin autofluorescence (SAF). Multivariate analyses identified female sex, %CV, MODD, and nephropathy stage as independent correlates of d-ROMs (adjusted R² = 0.436). Duration of diabetes, MODD, urinary albumin-to-creatinine ratio, and macroangiopathy were independently associated with SAF (adjusted R² = 0.265). This study suggests that short- and intermediate-term glycemic variability correlate with oxidative stress and AGE accumulation, which may be associated with vascular complications in T2DM.