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Diabetes Res Clin Pract. 2014 Sep;105(3):273-84. doi: 10.1016/j.diabres.2014.06.007. Epub 2014 Jun 23.

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

Author information

1
Ossian Health Economics and Communications, Basel, Switzerland. Electronic address: smith-palmer@ossianconsulting.com.
2
Kantonsspital St. Gallen, St. Gallen, Switzerland.
3
Ospedali Riuniti di Bergamo, Bergamo, Italy.
4
Medtronic Italia, S.p.A, Milano, Italy.
5
Medtronic International Trading Sàrl, Tolochenaz, Switzerland.
6
Ossian Health Economics and Communications, Basel, Switzerland.

Abstract

Chronic hyperglycemia is the main risk factor for the development of diabetes-related complications in both type 1 and type 2 diabetes, but it is thought that frequent or large glucose fluctuations may contribute independently to diabetes-related complications. A systematic literature review was performed using the PubMed, EMBASE and Cochrane Library databases with searches limited to studies published from June 2002 to March 2014, in English and including ≥50 patients. Twenty eight articles were included in the final review. Eighteen studies reported the association between glucose variability and diabetes-related complications exclusively in type 2 diabetes. A positive association between increased variability and microvascular complications and coronary artery disease was consistently reported. Associations between glucose variability and other macrovascular complications were inconsistent in type 2 diabetes. Seven studies examined the association between glucose variability and complications exclusively in type 1 diabetes. Increased glucose variability appears to play a minimal role in the development of micro- and macrovascular complications in type 1 diabetes. Consistent findings suggest that in type 2 diabetes glucose variability is associated with development of microvascular complications. The role of increased glucose variability in terms of microvascular and macrovascular complications in type 1 diabetes is less clear; more data in are needed.

KEYWORDS:

Glycemic variability; Macrovascular complications; Microvascular complications

PMID:
25023992
DOI:
10.1016/j.diabres.2014.06.007
[Indexed for MEDLINE]

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