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    Diabetes Care. 2009 Oct;32(10):1901-3. Epub 2009 Jun 23.

    Effect of glucose variability on the long-term risk of microvascular complications in type 1 diabetes.

    Kilpatrick ES, Rigby AS, Atkin SL.

    Department of Clinical Biochemistry, Hull Royal Infirmary, Hull, UK. eric.kilpatrick@hey.nhs.uk

    OBJECTIVE: This study analyzed data from the Epidemiology of Diabetes Interventions and Complications (EDIC) study to see whether longer-term follow-up of Diabetes Control and Complications Trial (DCCT) patients reveals a role for glycemic instability in the development of microvascular complications. RESEARCH DESIGN AND METHODS: The mean area under the curve glucose and the within-day glucose variability (SD and mean amplitude of glycemic excursions [MAGE]) during the DCCT were assessed to see whether they contributed to the risk of retinopathy and nephropathy by year 4 of the EDIC. RESULTS: Logistic regression analysis showed that mean glucose during the DCCT and mean A1C during EDIC were independently predictive of retinopathy (each P < 0.001) as well as A1C during EDIC of nephropathy (P = 0.001) development by EDIC year 4. Glucose variability did not add to this (all P > 0.25 using SD or MAGE). CONCLUSIONS: Glucose variability in the DCCT did not predict the development of retinopathy or nephropathy by EDIC year 4.

    PMID: 19549736 [PubMed - in process]

    PMCID: 2752912

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