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• W2000974725 abstract "Keywords Diabetes.Endothelialdysfunction.Glucosecontrol.Glycaemicvariability.Oxidativestress.VascularAbbreviationsCONGAn Continuous overall net glycaemic actionDM DiabeticGGC Good glycaemic controlMAGE Mean amplitude of glycaemic excursionsPGC Poor glycaemic controlTo the Editor: In their letter, Zaccardi and colleagues [1]express their opinion that the conclusion of our study [2],namely that ‘the oscillation of blood glucose level itselfis a more important contributor to the loss of endothelialfunction in diabetes than the average level of mean bloodglucose level per se’, is not completely supported by ourdata. The reason, as stated in their comments, is that wedid not perform objective mathematical calculations ofthe various indices of glycaemic variability, such as meanamplitude of glycaemic excursions (MAGE), standarddeviation, continuous overall net glycaemic action(CONGAn), and others.We are well aware of the various mathematical modelsdeveloped for the estimation of blood glucose variabilityfrom data collected in the clinical setting mentioned by ouresteemed colleagues [1]. These calculations are based onblood glucose concentrations in human patients: thesepatients have a circadian rhythm in their glucose metabo-lism and multiple postprandial glucose elevations over 24 h[3]. These models, with some modifications, can also beapplied to our animal studies in order to compare the datafrom the control, diabetic (DM), diabetic/good glycaemiccontrol (DM-GGC) and diabetic/poor glycaemic control(DM-PGC) animals. However, the circumstances in whichour data were collected differ from those collected in theclinical setting in that: (1) the rats were fed ad libitum,making it impossible to examine postprandial glucoseelevation; (2) the period of the glucose fluctuation was setto a 48 h cycle (as opposed to a 24 h cycle) in the DM-PGCgroup. The results, using appropriately modified formulasfor calculations, show that standard deviation, MAGE andCONGAn (12 h) are, indeed, significantly higher in theDM-PGC than in the DM group (Table 1).Thus, in our experimental animal model, the DM-PGCgroup had lower AUC values for plasma glucose levelsover time and lower fructosamine levels than the DMgroup, while exhibiting markedly higher blood glucosevariability. Strikingly, it was the DM-PGC group that hadthe highest degree of endothelial dysfunction and poly-(ADP-ribose) polymerase activation. Thus, we feel that theresults shown in our original article [2], as well as theadditional calculations contained in Table 1 here, continueto support our conclusion that it is the oscillation of bloodglucose level itself, and not the average level of mean blood" @default.
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• W2000974725 date "2009-05-26" @default.
• W2000974725 modified "2023-09-26" @default.
• W2000974725 title "A rat model of glycaemic variability. Reply to Zaccardi F, Pitocco D, Ghirlanda G [letter]" @default.
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• W2000974725 doi "https://doi.org/10.1007/s00125-009-1396-6" @default.
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