Glucose variability for cardiovascular risk factors in type 2 diabetes: a meta-analysis

AIMS: It is consensus that glucose variability (GV) plays an important role in maccomplications of type 2 diabetes, but whether GV has a causal role is not yet clear for cardiovascular disease (CVD). This study sought to explore the effect on GV for CVD risk factors with type 2 diabetes. METHODS: The systematic literature search was performed to identify all GV and CVD risk factors, including total cholesterol (TC), LDL cholesterol (LDL-C), triglyceride (TG), HDL cholesterol (HDL-C), Body Mass Index (BMI), waist circumference (WC), High-Sensitivity C-reactive protein (Hs-CRP), Homeostasis model assessment (HOMA) and carotid intima-media thickness (IMT). Preferred Reporting Items was synthesized for Systematic reviews and Meta Analyses guideline. And the pooled analyses were undertaken using Review Manager 5.3. RESULTS: Twenty two studies were included with a total of 1143 patients in high glucose variability group (HGVG) and 1275 patients low glucose variability group (LGVG). Among these selected CVD risk factors, HOMA-IR and reduced IMT were affected by GV. HOMA-IR level was significantly lower in LGVG than in HGVG (MD = 0.58, 95% CI: 0.26 to 0.91, P = 0.0004), with evidence of heterogeneity between studies (I(2) = 0%; P = 0.47). Reduced IMT level was significantly lower in LGVG than in HGVG (SMD = 0.28, 95% CI: 0.09 to 0.47, P = 0.003), with evidence of heterogeneity between studies (I(2) = 0%; P = 0.48). However, the others were no significant statistical difference. CONCLUSIONS: Among these selected CVD risk factors in type 2 diabetes, minimizing GV could improve insulin resistance and reduced IMT, consistent with a lowering in risk of CVD. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40200-017-0323-5) contains supplementary material, which is available to authorized users.