Association of lower body mass index with increased glycemic variability in patients with newly diagnosed type 2 diabetes: a cross-sectional study in China

Previous studies have indicated that the pathogenesis of diabetes differs between obese and lean patients. We investigated whether newly diagnosed Chinese diabetic patients with different body mass indices (BMIs) have different glycemic variability, and we assessed the relationship between BMI and glycemic variability. This was a cross-sectional study that included 169 newly diagnosed and drug-naive type 2 diabetic patients (mean age, 51.33 +/- 9.83 years; 110 men). The clinical factors and results of the 75-g oral glucose tolerance test were all recorded. Glycemic variability was assessed using continuous glucose monitoring. Compared with overweight or obese patients (BMI >= 24 kg/m(2)), underweight or normal-weight patients (BMI < 24 kg/m(2)) had higher levels of blood glucose fluctuation parameters, particularly in terms of mean amplitude of glycemic excursion (MAGE 6.64 +/- 2.38 vs. 5.67 +/- 2.05; P = 0.007) and postprandial glucose excursions (PPGEs) (PPGE at breakfast, 7.72 +/- 2.79 vs. 6.79 +/- 2.40, P = 0.028; PPGE at lunch, 5.53 +/- 2.70 vs. 5.07 +/- 2.40, P = 0.285; PPGE at dinner, 5.96 +/- 2.24 vs. 4.87 +/- 2.50, P = 0.008). BMI was negatively correlated with glycemic variability (r = -0.243, P = 0.002). On multiple linear regression analyses, BMI (beta = -0.231, P = 0.013) and Insulin Secretion Sensitivity Index-2 (beta = -0.204, P = 0.048) were two independent predictors of glycemic variability. In conclusion, lower BMI was associated with increased glycemic variability, characterized by elevated PPGEs, in newly diagnosed Chinese type 2 diabetic patients.