Can glycaemic variability, as calculated from blood glucose self-monitoring, predict the development of complications in type 1 diabetes over a decade?

Bragd, Joakim; Adamson, Ulf; Bäcklund, L; Lins, Per‐Eric; Moberg, Erik; Oskarsson, Per

doi:10.1016/j.diabet.2008.04.005

Cited by 136 publications

(125 citation statements)

References 18 publications

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“…Of note, previous reports suggested that acute oscillations of blood glucose have a more deleterious effect on endothelial function than constant hyperglycemia in patients with type 2 diabetes (T2DM) (3,4), which may support the concept that glycemic variability can induce oxidative stress and thereby affect the pathophysiologic pathways through which diabetes complications arise (5). However, although some studies have reported that increased glycemic variability may be associated with the incidence of diabetic retinopathy (6,7), diabetic neuropathy (8), and coronary artery calcification (9) in patients with T2DM and type 1 diabetes (T1DM), other studies have not supported this association (10)(11)(12). Nevertheless, although its relevance to vascular complications remains uncertain (13), at a given level of glycemia, increased glucose variability raises the risk of hypoglycemia (14)(15)(16) and, hence, is clinically important.…”

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confidence: 54%

Glycemic Variability in Patients With Early Type 2 Diabetes: The Impact of Improvement in β-Cell Function

et al. 2014

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OBJECTIVEIncreased glycemic variability has been reported to be associated with the risk of hypoglycemia and possibly diabetes complications and is believed to be due to b-cell dysfunction. However, it is not known whether improvement in b-cell function can reduce glycemic variability. Because short-term intensive insulin therapy (IIT) can improve b-cell function in early type 2 diabetes (T2DM), our objective was to determine whether the b-cell functional recovery induced by this therapy is associated with decreased glycemic variability. RESEARCH DESIGN AND METHODSSixty-one patients with T2DM of 3.0 years mean duration underwent 4 weeks of IIT, which consisted of basal insulin detemir and premeal insulin aspart. Glucose variability was assessed in both the first and the last week by the coefficient of variation of capillary glucose on daily 6-point self-monitoring profiles. b-Cell function before and after IIT was assessed with the Insulin Secretion-Sensitivity Index-2 (ISSI-2). RESULTSBetween the first and the last week on IIT, 55.7% of patients had a reduction in glucose variability. Change in glucose variability was negatively correlated with the change in b-cell function (ISSI-2) (r = 20.34, P = 0.008). On multiple linear regression analyses, percentage change in ISSI-2 emerged as the only factor independently associated with the change in glucose variability (standardized b = 20.42, P = 0.03). Moreover, patients with an increase in ISSI-2 ‡25% experienced a reduction in glucose variability compared with their peers who had almost no change (20.041 6 0.06 vs. 20.0002 6 0.04, respectively; P = 0.006). CONCLUSIONSIn early T2DM, glycemic variability is a modifiable parameter that can be reduced by improving b-cell function with short-term IIT.

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confidence: 54%

Glycemic Variability in Patients With Early Type 2 Diabetes: The Impact of Improvement in β-Cell Function

et al. 2014

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“…показали наличие таких периодов продолжительностью 48 ч перед тяжелой гипогликемией и после нее [9]. Вы-числение SD значений глюкозы крови, полученных па-циентами с СД1 при самоконтроле в течение месяца (100 определений), позволяет предсказать формирование феномена нарушенного распознавания гипогликемий через 11 лет течения заболевания [46].…”

Section: риск гипогликемийunclassified

Glycaemic variability in diabetes: a tool for assessing the quality of glycaemic control and the risk of complications

Климонтов¹,

Myakina²

2014

Diabetes mellitus

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Glycaemic variability in diabetes: a tool for assessing the quality of glycaemic control and the risk of complicationsKlimontov V.V., Myakina N.E. Institute of Clinical and Experimental Lymphology, Novosibirsk, Russian Federation The routine approach to evaluating the effectiveness of diabetes treatment based on the level of glycated haemoglobin (HbA 1c ) accounts for the average glucose level but does not consider the scope and frequency of its fluctuations. The development of computational methods to analyse glycaemic oscillations has made it possible to propose the concept of glycaemic variability (GV). The interest in research focused on GV increased dramatically after continuous glucose monitoring (CGM) technology was introduced, which provided the opportunity to study in detail the

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“…There is debate on whether glycemic variability is associated with a risk of microvascular complications [18,19]. However, several studies have reported that postprandial hyperglycemia or fluctuations in glucose levels is an independent risk factor for chronic complications of diabetes [20]. Marked glucose fluctuations cause oxidative stress and chronic complications [21].…”

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confidence: 99%

Three-day continuous glucose monitoring for rapid assessment of hypoglycemic events and glycemic variability in type 1 diabetic patients

et al. 2011

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Can glycaemic variability, as calculated from blood glucose self-monitoring, predict the development of complications in type 1 diabetes over a decade?

Cited by 136 publications

References 18 publications

Glycemic Variability in Patients With Early Type 2 Diabetes: The Impact of Improvement in β-Cell Function

Glycemic Variability in Patients With Early Type 2 Diabetes: The Impact of Improvement in β-Cell Function

Glycaemic variability in diabetes: a tool for assessing the quality of glycaemic control and the risk of complications

Three-day continuous glucose monitoring for rapid assessment of hypoglycemic events and glycemic variability in type 1 diabetic patients

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