Hsu Cherng-Ru, Chen Yu-Tsung, Sheu Wayne H-H
Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
J Diabetes Complications. 2015 Mar;29(2):302-6. doi: 10.1016/j.jdiacomp.2014.11.013. Epub 2014 Dec 3.
Daily glucose variability, such as fasting plasma glucose fluctuation or postprandial hyperglycemia, has been proposed as contributors to diabetes-related macrovascular complications. However, its impacts on microvascular complications, such as diabetes retinopathy remain controversial. We reviewed the current evidence of the relationship between glycemic variability and diabetes retinopathy in patients with type 1 or type 2 diabetes. In general, the short-term glycemic fluctuation, either expressed as standard deviation of fasting glucose or mean glucose levels, may contribute to the development or progression of diabetic retinopathy in patients with type 2 diabetes, whereas long-term glycemic fluctuation, reflected by variation of levels of HbA1c, appeared to show a stronger association with diabetes retinopathy both in patients with type 1 and type 2 diabetes. These findings emphasize the need to reduce glycemic variability by various measures in order to reduce development and progression of diabetes retinopathy both in type 1 and type 2 diabetes patients.
每日血糖变异性，如空腹血糖波动或餐后高血糖，已被认为是糖尿病相关大血管并发症的促成因素。然而，其对糖尿病视网膜病变等微血管并发症的影响仍存在争议。我们回顾了1型或2型糖尿病患者血糖变异性与糖尿病视网膜病变之间关系的现有证据。一般来说，短期血糖波动，无论是以空腹血糖标准差还是平均血糖水平表示，可能会导致2型糖尿病患者糖尿病视网膜病变的发生或进展，而由糖化血红蛋白水平变化反映的长期血糖波动，在1型和2型糖尿病患者中似乎都与糖尿病视网膜病变有更强的关联。这些发现强调了需要通过各种措施降低血糖变异性，以减少1型和2型糖尿病患者糖尿病视网膜病变的发生和进展。
