Assessment of the association between glycemic variability and diabetes-related complications in type 1 and type 2 diabetes

: Chronic hyperglycemia is an established risk factor for the development of complications in both type 1 and type 2 diabetes, but glycemic variability has emerged as a possible independent risk factor for diabetes complications, possibly throughout oxidative stress. In this review we discuss methods to access glycemic variability and oxidative stress, as well as their correlations. We also debate non-pharmacological and pharmacological strategies to achieve a better glycemic control, not only by HbA1c target, but also with reduced glycemic fluctuations, possibly minimizing the risk of diabetes complications.

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Comparative Effectiveness of Basal-BolusVersusPremix Analog Insulin on Glycemic Variability and Patient-Centered Outcomes during Insulin Intensification in Type 1 and Type 2 Diabetes: A Randomized, Controlled, Crossover Trial

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2012-1763 ◽

2012 ◽

Vol 97 (10) ◽

pp. 3504-3514 ◽

Cited By ~ 34

Author(s):

Marcia A. Testa ◽

Jasvinder Gill ◽

Max Su ◽

Ralph R. Turner ◽

Lawrence Blonde ◽

...

Keyword(s):

Type 2 Diabetes ◽

Comparative Effectiveness ◽

Crossover Trial ◽

Glycemic Variability ◽

Patient Centered ◽

Insulin Intensification ◽

Randomized Controlled ◽

Analog Insulin

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Glycemic Variability in Inadequately Controlled Type 1 Diabetes and Type 2 Diabetes on Intensive Insulin Therapy: A Cross-Sectional, Observational Study

Diabetes Technology & Therapeutics ◽

10.1089/dia.2010.0044 ◽

2010 ◽

Vol 12 (9) ◽

pp. 695-699 ◽

Cited By ~ 19

Author(s):

Wendela L. Greven ◽

Joline W.J. Beulens ◽

Douwe H. Biesma ◽

Sandra Faiz ◽

Harold W. de Valk

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Observational Study ◽

Insulin Therapy ◽

Intensive Insulin Therapy ◽

Glycemic Variability ◽

Cross Sectional

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Frequency and Predictors of Self-Reported Hypoglycemia in Insulin-Treated Diabetes

Journal of Diabetes Research ◽

10.1155/2017/7425925 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Samir Malkani ◽

Anupam Kotwal

Keyword(s):

Type 2 Diabetes ◽

Blood Glucose ◽

Positive Association ◽

Glycemic Variability ◽

Negative Association ◽

Ambulatory Setting ◽

Duration Of Diabetes ◽

Increased Risk

Aims. Hypoglycemia is a limiting factor for achieving stringent glycemic control in diabetes. This study analyzes the frequency and predictors of hypoglycemia in insulin-treated diabetes in an ambulatory setting. Methods. A retrospective chart review was performed to study self-monitored blood glucose (SMBG) data for 3 months prior to a patient’s HbA1c test. Results. Hypoglycemia occurred more frequently in type 1 than in type 2 diabetes; however, 19% of type 2 diabetes patients did experience at least one episode of severe hypoglycemia. For type 1 diabetes, hypoglycemia had a positive association with glycemic variability and duration of diabetes and a negative association with HbA1c and lowest blood glucose (BG). For type 2 diabetes, a positive association was noted with glycemic variability and a negative association with age and lowest BG. Conclusions. Delineating factors predisposing to hypoglycemia in type 2 diabetes is difficult. Lower HbA1c is a potential predictor of hypoglycemia in type 1 but not in type 2 diabetes. Longer duration of diabetes for type 1 and younger age for type 2 are associated with more hypoglycemia. Glycemic variability portends increased risk for hypoglycemia and should be a focus of further research.

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