Recently, in the International Journal of Rheumatic Diseases, "Blood glucose fluctuations detected by continuous glucose monitoring system in gout patients with normal glucose tolerance and the effect of urate-lowering therapy" published by domestic researchers Continuous blood glucose monitoring in healthy people found that patients with gout had far greater fluctuations in blood glucose than healthy people under normal glucose tolerance.
The research method they adopted was 30 new gout patients with normal glucose tolerance. The patients were all males, with ages ranging from 20 to 70 years old, and blood uric acid content exceeding 420 mmol/L. The entire study was conducted for 2 weeks. Any diabetic patients, or pre-diabetic patients, patients with gout attacks within 1 week, patients taking blood glucose within 1 month, patients with other chronic diseases (such as liver and kidney diseases), etc. are not subject to the experiment.
After 2 weeks of monitoring, the researchers found:
1) Gout patients have higher mean amplitude of glucose excursions (MAGE), 4.65 vs 1.94 mmol/L, P <.001, which is 2.4 times that of healthy people;
2) Gout patients have a higher maximum amplitude of blood glucose excursions (LAGE), 4.99 vs 3.72 mmol/L, P <.001, which is 1.3 times that of healthy people;
3) The standard deviations of blood glucose (SDBG) in gout patients are also higher, 1.36 vs 0.79 mmol/L, P <.001, which is 1.7 times that of healthy people;
4) Surprisingly, the 24-hour mean blood glucose [Twenty-four-hour mean blood glucose (MBG)] of gout patients and healthy people is not much different, 5.84 vs 5.78 mmol/L, P=.627. The study also found that allopurinol drugs that reduce uric acid can also reduce MAGE, LAGE, and SDBG while reducing uric acid.
The study provides new ideas for solving the diabetes risk of gout patients. Type 2 diabetes complicated by gout patients is often accompanied by insulin resistance. Past studies have suggested that uric acid can lead to insulin resistance by inducing mitochondrial oxidative stress and weakening the stimulation of nitric oxide by endothelial cells. At the same time, higher serum uric acid levels may reduce insulin clearance by impairing hepatic insulin sensitivity, and inhibit the growth of pancreatic islet β cells, thereby increasing insulin resistance. The study found that patients with gout have a very large change in blood glucose under the apparent phenomenon of normal average blood glucose, which may affect the vitality of insulin.
Instantaneous changes in high blood sugar can cause damage to human tissues and organs, and blood sugar fluctuations are an important factor in the causative factors of diabetes and its complications. In addition, large blood glucose fluctuations may promote the activation of oxidative stress by enhancing the activity of nuclear factor κB and protein kinase C, which leads to the increase of advanced glycosylation end products and the promotion of endothelial cell apoptosis, thereby accelerating the arteries The development of atherosclerosis.
In general, for patients with𝓰 gout, mo♛nitoring uric acid and blood sugar is very beneficial to improve the quality of life and risk of complications.