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Published in: Cardiovascular Diabetology 1/2021

Open Access 01-12-2021 | Diabetic Retinopathy | Review

Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications

Authors: Bao Sun, Zhiying Luo, Jiecan Zhou

Published in: Cardiovascular Diabetology | Issue 1/2021

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Abstract

Diabetes mellitus is the major risk factor for the development of macrovascular and microvascular complications. It is increasingly recognized that glycemic variability (GV), referring to oscillations in blood glucose levels and representing either short-term or long-term GV, is involved in the pathogenesis of diabetic complications and has emerged as a possible independent risk factor for them. In this review, we summarize the metrics and measurement of GV in clinical practice, as well as comprehensively elaborate the role and related mechanisms of GV in diabetic macrovascular and microvascular complications, aiming to provide the mechanism-based therapeutic strategies for clinicians to manage diabetes mellitus.
Literature
1.
go back to reference American Diabetes Association. Clinical practice recommendations 2008. Diabetes Care. 2008;31(Suppl 1):12–54.CrossRef American Diabetes Association. Clinical practice recommendations 2008. Diabetes Care. 2008;31(Suppl 1):12–54.CrossRef
3.
go back to reference Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, Ingelsson E, Lawlor DA, Selvin E, Stampfer M, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215–22.PubMedCrossRef Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, Ingelsson E, Lawlor DA, Selvin E, Stampfer M, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215–22.PubMedCrossRef
4.
go back to reference Cavender MA, Steg PG, Smith SC Jr, Eagle K, Ohman EM, Goto S, Kuder J, Im K, Wilson PW, Bhatt DL. Impact of Diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: outcomes at 4 years from the reduction of atherothrombosis for Continued Health (REACH) Registry. Circulation. 2015;132(10):923–31.PubMedCrossRef Cavender MA, Steg PG, Smith SC Jr, Eagle K, Ohman EM, Goto S, Kuder J, Im K, Wilson PW, Bhatt DL. Impact of Diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: outcomes at 4 years from the reduction of atherothrombosis for Continued Health (REACH) Registry. Circulation. 2015;132(10):923–31.PubMedCrossRef
5.
go back to reference Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham study. Diabetes Care. 1979;2(2):120–6.PubMedCrossRef Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham study. Diabetes Care. 1979;2(2):120–6.PubMedCrossRef
7.
go back to reference Santiago JV. Lessons from the diabetes control and complications trial. Diabetes. 1993;42(11):1549–54.PubMedCrossRef Santiago JV. Lessons from the diabetes control and complications trial. Diabetes. 1993;42(11):1549–54.PubMedCrossRef
9.
go back to reference Wang A, Liu X, Xu J, Han X, Su Z, Chen S, Zhang N, Wu S, Wang Y, Wang Y. Visit-to-visit variability of fasting plasma glucose and the risk of cardiovascular disease and all-cause mortality in the general population. J Am Heart Assoc. 2017;6(12):e006757.PubMedPubMedCentralCrossRef Wang A, Liu X, Xu J, Han X, Su Z, Chen S, Zhang N, Wu S, Wang Y, Wang Y. Visit-to-visit variability of fasting plasma glucose and the risk of cardiovascular disease and all-cause mortality in the general population. J Am Heart Assoc. 2017;6(12):e006757.PubMedPubMedCentralCrossRef
10.
go back to reference Zhou JJ, Schwenke DC, Bahn G, Reaven P. Glycemic variation and cardiovascular risk in the veterans affairs diabetes trial. Diabetes Care. 2018;41(10):2187–94.PubMedPubMedCentralCrossRef Zhou JJ, Schwenke DC, Bahn G, Reaven P. Glycemic variation and cardiovascular risk in the veterans affairs diabetes trial. Diabetes Care. 2018;41(10):2187–94.PubMedPubMedCentralCrossRef
11.
go back to reference Lin CC, Yang CP, Li CI, Liu CS, Chen CC, Lin WY, Hwang KL, Yang SY, Li TC. Visit-to-visit variability of fasting plasma glucose as predictor of ischemic stroke: competing risk analysis in a national cohort of Taiwan Diabetes Study. BMC Med. 2014;12:165.PubMedPubMedCentralCrossRef Lin CC, Yang CP, Li CI, Liu CS, Chen CC, Lin WY, Hwang KL, Yang SY, Li TC. Visit-to-visit variability of fasting plasma glucose as predictor of ischemic stroke: competing risk analysis in a national cohort of Taiwan Diabetes Study. BMC Med. 2014;12:165.PubMedPubMedCentralCrossRef
12.
go back to reference Hirakawa Y, Arima H, Zoungas S, Ninomiya T, Cooper M, Hamet P, Mancia G, Poulter N, Harrap S, Woodward M, et al. Impact of visit-to-visit glycemic variability on the risks of macrovascular and microvascular events and all-cause mortality in type 2 diabetes: the ADVANCE trial. Diabetes Care. 2014;37(8):2359–65.PubMedCrossRef Hirakawa Y, Arima H, Zoungas S, Ninomiya T, Cooper M, Hamet P, Mancia G, Poulter N, Harrap S, Woodward M, et al. Impact of visit-to-visit glycemic variability on the risks of macrovascular and microvascular events and all-cause mortality in type 2 diabetes: the ADVANCE trial. Diabetes Care. 2014;37(8):2359–65.PubMedCrossRef
13.
go back to reference Hirsch IB. Glycemic variability and diabetes complications: does it matter? Of course it does! Diabetes care. 2015;38(8):1610–4.PubMedCrossRef Hirsch IB. Glycemic variability and diabetes complications: does it matter? Of course it does! Diabetes care. 2015;38(8):1610–4.PubMedCrossRef
14.
go back to reference Bergenstal RM. Glycemic variability and diabetes complications: does it matter? Simply put, there are better glycemic markers! Diabetes care. 2015;38(8):1615–21.PubMedCrossRef Bergenstal RM. Glycemic variability and diabetes complications: does it matter? Simply put, there are better glycemic markers! Diabetes care. 2015;38(8):1615–21.PubMedCrossRef
15.
go back to reference Sun B, He F, Gao Y, Zhou J, Sun L, Liu R, Xu H, Chen X, Zhou H, Liu Z, et al. Prognostic impact of visit-to-visit glycemic variability on the risks of major adverse cardiovascular outcomes and hypoglycemia in patients with different glycemic control and type 2 diabetes. Endocrine. 2019;64(3):536–43.PubMedCrossRef Sun B, He F, Gao Y, Zhou J, Sun L, Liu R, Xu H, Chen X, Zhou H, Liu Z, et al. Prognostic impact of visit-to-visit glycemic variability on the risks of major adverse cardiovascular outcomes and hypoglycemia in patients with different glycemic control and type 2 diabetes. Endocrine. 2019;64(3):536–43.PubMedCrossRef
16.
17.
go back to reference Frontoni S, Di Bartolo P, Avogaro A, Bosi E, Paolisso G, Ceriello A. Glucose variability: an emerging target for the treatment of diabetes mellitus. Diabetes Res Clin Pract. 2013;102(2):86–95.PubMedCrossRef Frontoni S, Di Bartolo P, Avogaro A, Bosi E, Paolisso G, Ceriello A. Glucose variability: an emerging target for the treatment of diabetes mellitus. Diabetes Res Clin Pract. 2013;102(2):86–95.PubMedCrossRef
18.
go back to reference Kovatchev BP. Metrics for glycaemic control—from HbA(1c) to continuous glucose monitoring. Nat Rev Endocrinol. 2017;13(7):425–36.PubMedCrossRef Kovatchev BP. Metrics for glycaemic control—from HbA(1c) to continuous glucose monitoring. Nat Rev Endocrinol. 2017;13(7):425–36.PubMedCrossRef
19.
go back to reference Gorst C, Kwok CS, Aslam S, Buchan I, Kontopantelis E, Myint PK, Heatlie G, Loke Y, Rutter MK, Mamas MA. Long-term glycemic variability and risk of adverse outcomes: a systematic review and meta-analysis. Diabetes care. 2015;38(12):2354–69.PubMedCrossRef Gorst C, Kwok CS, Aslam S, Buchan I, Kontopantelis E, Myint PK, Heatlie G, Loke Y, Rutter MK, Mamas MA. Long-term glycemic variability and risk of adverse outcomes: a systematic review and meta-analysis. Diabetes care. 2015;38(12):2354–69.PubMedCrossRef
20.
go back to reference Lachin JM, Bebu I, Bergenstal RM, Pop-Busui R, Service FJ, Zinman B, Nathan DM. Association of glycemic variability in type 1 diabetes with progression of microvascular outcomes in the diabetes control and complications trial. Diabetes Care. 2017;40(6):777–83.PubMedPubMedCentralCrossRef Lachin JM, Bebu I, Bergenstal RM, Pop-Busui R, Service FJ, Zinman B, Nathan DM. Association of glycemic variability in type 1 diabetes with progression of microvascular outcomes in the diabetes control and complications trial. Diabetes Care. 2017;40(6):777–83.PubMedPubMedCentralCrossRef
21.
go back to reference Kilpatrick ES, Rigby AS, Atkin SL. A1C variability and the risk of microvascular complications in type 1 diabetes: data from the Diabetes Control and Complications Trial. Diabetes Care. 2008;31(11):2198–202.PubMedPubMedCentralCrossRef Kilpatrick ES, Rigby AS, Atkin SL. A1C variability and the risk of microvascular complications in type 1 diabetes: data from the Diabetes Control and Complications Trial. Diabetes Care. 2008;31(11):2198–202.PubMedPubMedCentralCrossRef
22.
go back to reference Rothwell PM, Howard SC, Dolan E, O’Brien E, Dobson JE, Dahlöf B, Sever PS, Poulter NR. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010;375(9718):895–905.PubMedCrossRef Rothwell PM, Howard SC, Dolan E, O’Brien E, Dobson JE, Dahlöf B, Sever PS, Poulter NR. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010;375(9718):895–905.PubMedCrossRef
24.
go back to reference Service FJ, Molnar GD, Rosevear JW, Ackerman E, Gatewood LC, Taylor WF. Mean amplitude of glycemic excursions, a measure of diabetic instability. Diabetes. 1970;19(9):644–55.PubMedCrossRef Service FJ, Molnar GD, Rosevear JW, Ackerman E, Gatewood LC, Taylor WF. Mean amplitude of glycemic excursions, a measure of diabetic instability. Diabetes. 1970;19(9):644–55.PubMedCrossRef
25.
go back to reference McDonnell CM, Donath SM, Vidmar SI, Werther GA, Cameron FJ. A novel approach to continuous glucose analysis utilizing glycemic variation. Diabetes Technol Ther. 2005;7(2):253–63.PubMedCrossRef McDonnell CM, Donath SM, Vidmar SI, Werther GA, Cameron FJ. A novel approach to continuous glucose analysis utilizing glycemic variation. Diabetes Technol Ther. 2005;7(2):253–63.PubMedCrossRef
26.
go back to reference Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen SJ, Dekker JM, Fletcher A, Grauslund J, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35(3):556–64.PubMedPubMedCentralCrossRef Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen SJ, Dekker JM, Fletcher A, Grauslund J, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35(3):556–64.PubMedPubMedCentralCrossRef
27.
go back to reference Battelino T, Danne T, Bergenstal RM, Amiel SA, Beck R, Biester T, Bosi E, Buckingham BA, Cefalu WT, Close KL, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care. 2019;42(8):1593–603.PubMedPubMedCentralCrossRef Battelino T, Danne T, Bergenstal RM, Amiel SA, Beck R, Biester T, Bosi E, Buckingham BA, Cefalu WT, Close KL, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care. 2019;42(8):1593–603.PubMedPubMedCentralCrossRef
28.
go back to reference Molnar GD, Taylor WF, Ho MM. Day-to-day variation of continuously monitored glycaemia: a further measure of diabetic instability. Diabetologia. 1972;8(5):342–8.PubMedCrossRef Molnar GD, Taylor WF, Ho MM. Day-to-day variation of continuously monitored glycaemia: a further measure of diabetic instability. Diabetologia. 1972;8(5):342–8.PubMedCrossRef
29.
go back to reference Bailey T, Bode BW, Christiansen MP, Klaff LJ, Alva S. The performance and usability of a factory-calibrated flash glucose monitoring system. Diabetes Technol Ther. 2015;17(11):787–94.PubMedPubMedCentralCrossRef Bailey T, Bode BW, Christiansen MP, Klaff LJ, Alva S. The performance and usability of a factory-calibrated flash glucose monitoring system. Diabetes Technol Ther. 2015;17(11):787–94.PubMedPubMedCentralCrossRef
30.
go back to reference Hoss U, Budiman ES. Factory-calibrated continuous glucose sensors: the science behind the technology. Diabetes Technol Ther. 2017;19(S2):44-s50.CrossRef Hoss U, Budiman ES. Factory-calibrated continuous glucose sensors: the science behind the technology. Diabetes Technol Ther. 2017;19(S2):44-s50.CrossRef
31.
go back to reference Kovatchev BP, Cox DJ, Gonder-Frederick LA, Clarke W. Symmetrization of the blood glucose measurement scale and its applications. Diabetes Care. 1997;20(11):1655–8.PubMedCrossRef Kovatchev BP, Cox DJ, Gonder-Frederick LA, Clarke W. Symmetrization of the blood glucose measurement scale and its applications. Diabetes Care. 1997;20(11):1655–8.PubMedCrossRef
32.
33.
go back to reference Hill NR, Oliver NS, Choudhary P, Levy JC, Hindmarsh P, Matthews DR. Normal reference range for mean tissue glucose and glycemic variability derived from continuous glucose monitoring for subjects without diabetes in different ethnic groups. Diabetes Technol Ther. 2011;13(9):921–8.PubMedPubMedCentralCrossRef Hill NR, Oliver NS, Choudhary P, Levy JC, Hindmarsh P, Matthews DR. Normal reference range for mean tissue glucose and glycemic variability derived from continuous glucose monitoring for subjects without diabetes in different ethnic groups. Diabetes Technol Ther. 2011;13(9):921–8.PubMedPubMedCentralCrossRef
34.
go back to reference Danne T, Nimri R, Battelino T, Bergenstal RM, Close KL, DeVries JH, Garg S, Heinemann L, Hirsch I, Amiel SA, et al. International consensus on use of continuous glucose monitoring. Diabetes Care. 2017;40(12):1631–40.PubMedPubMedCentralCrossRef Danne T, Nimri R, Battelino T, Bergenstal RM, Close KL, DeVries JH, Garg S, Heinemann L, Hirsch I, Amiel SA, et al. International consensus on use of continuous glucose monitoring. Diabetes Care. 2017;40(12):1631–40.PubMedPubMedCentralCrossRef
35.
go back to reference Borot S, Benhamou PY, Atlan C, Bismuth E, Bonnemaison E, Catargi B, Charpentier G, Farret A, Filhol N, Franc S, et al. Practical implementation, education and interpretation guidelines for continuous glucose monitoring: a French position statement. Diabetes Metab. 2018;44(1):61–72.PubMedCrossRef Borot S, Benhamou PY, Atlan C, Bismuth E, Bonnemaison E, Catargi B, Charpentier G, Farret A, Filhol N, Franc S, et al. Practical implementation, education and interpretation guidelines for continuous glucose monitoring: a French position statement. Diabetes Metab. 2018;44(1):61–72.PubMedCrossRef
36.
go back to reference Chico A, Aguilera E, Ampudia-Blasco FJ, Bellido V, Cardona-Hernández R, Escalada FJ, Fernández D, Gómez-Peralta F, González Pérez de Villar N, Gorgojo JJ, et al. Clinical approach to flash glucose monitoring: an expert recommendation. J Diabetes Sci Technol. 2020;14(1):155–64.PubMedCrossRef Chico A, Aguilera E, Ampudia-Blasco FJ, Bellido V, Cardona-Hernández R, Escalada FJ, Fernández D, Gómez-Peralta F, González Pérez de Villar N, Gorgojo JJ, et al. Clinical approach to flash glucose monitoring: an expert recommendation. J Diabetes Sci Technol. 2020;14(1):155–64.PubMedCrossRef
37.
go back to reference Nusca A, Tuccinardi D, Albano M, Cavallaro C, Ricottini E, Manfrini S, Pozzilli P, Di Sciascio G. Glycemic variability in the development of cardiovascular complications in diabetes. Diab/Metab Res Rev. 2018;34(8):e3047.CrossRef Nusca A, Tuccinardi D, Albano M, Cavallaro C, Ricottini E, Manfrini S, Pozzilli P, Di Sciascio G. Glycemic variability in the development of cardiovascular complications in diabetes. Diab/Metab Res Rev. 2018;34(8):e3047.CrossRef
38.
go back to reference Cardoso CRL, Leite NC, Moram CBM, Salles GF. Long-term visit-to-visit glycemic variability as predictor of micro- and macrovascular complications in patients with type 2 diabetes: The Rio de Janeiro Type 2 Diabetes Cohort Study. Cardiovasc Diabetol. 2018;17(1):33.PubMedPubMedCentralCrossRef Cardoso CRL, Leite NC, Moram CBM, Salles GF. Long-term visit-to-visit glycemic variability as predictor of micro- and macrovascular complications in patients with type 2 diabetes: The Rio de Janeiro Type 2 Diabetes Cohort Study. Cardiovasc Diabetol. 2018;17(1):33.PubMedPubMedCentralCrossRef
39.
go back to reference Takahashi H, Iwahashi N, Kirigaya J, Kataoka S, Minamimoto Y, Gohbara M, Abe T, Okada K, Matsuzawa Y, Konishi M, et al. Glycemic variability determined with a continuous glucose monitoring system can predict prognosis after acute coronary syndrome. Cardiovasc Diabetol. 2018;17(1):116.PubMedPubMedCentralCrossRef Takahashi H, Iwahashi N, Kirigaya J, Kataoka S, Minamimoto Y, Gohbara M, Abe T, Okada K, Matsuzawa Y, Konishi M, et al. Glycemic variability determined with a continuous glucose monitoring system can predict prognosis after acute coronary syndrome. Cardiovasc Diabetol. 2018;17(1):116.PubMedPubMedCentralCrossRef
40.
go back to reference Xia J, Yin C. Glucose variability and coronary artery disease. Heart Lung Circ. 2019;28(4):553–9.PubMedCrossRef Xia J, Yin C. Glucose variability and coronary artery disease. Heart Lung Circ. 2019;28(4):553–9.PubMedCrossRef
41.
go back to reference Scott ES, Januszewski AS, O’Connell R, Fulcher G, Scott R, Kesaniemi A, Wu L, Colagiuri S, Keech A, Jenkins AJ. Long-term glycemic variability and vascular complications in type 2 diabetes: post hoc analysis of the FIELD study. J Clin Endocrinol Metab. 2020;105(10):e3638–49.CrossRef Scott ES, Januszewski AS, O’Connell R, Fulcher G, Scott R, Kesaniemi A, Wu L, Colagiuri S, Keech A, Jenkins AJ. Long-term glycemic variability and vascular complications in type 2 diabetes: post hoc analysis of the FIELD study. J Clin Endocrinol Metab. 2020;105(10):e3638–49.CrossRef
42.
go back to reference Slieker RC, van der Heijden A, Nijpels G, Elders PJM, t Hart LM, Beulens JWJ. Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort. Cardiovasc Diabetol. 2019;18(1):170.PubMedPubMedCentralCrossRef Slieker RC, van der Heijden A, Nijpels G, Elders PJM, t Hart LM, Beulens JWJ. Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort. Cardiovasc Diabetol. 2019;18(1):170.PubMedPubMedCentralCrossRef
43.
go back to reference Liang S, Yin H, Wei C, Xie L, He H, Liu X. Glucose variability for cardiovascular risk factors in type 2 diabetes: a meta-analysis. J Diabetes Metab Disord. 2017;16:45.PubMedPubMedCentralCrossRef Liang S, Yin H, Wei C, Xie L, He H, Liu X. Glucose variability for cardiovascular risk factors in type 2 diabetes: a meta-analysis. J Diabetes Metab Disord. 2017;16:45.PubMedPubMedCentralCrossRef
44.
go back to reference Besch G, Pili-Floury S, Morel C, Gilard M, Flicoteaux G, Salomon du Mont L, Perrotti A, Meneveau N, Chocron S, Schiele F, et al. Impact of post-procedural glycemic variability on cardiovascular morbidity and mortality after transcatheter aortic valve implantation: a post hoc cohort analysis. Cardiovasc Diabetol. 2019;18(1):27.PubMedPubMedCentralCrossRef Besch G, Pili-Floury S, Morel C, Gilard M, Flicoteaux G, Salomon du Mont L, Perrotti A, Meneveau N, Chocron S, Schiele F, et al. Impact of post-procedural glycemic variability on cardiovascular morbidity and mortality after transcatheter aortic valve implantation: a post hoc cohort analysis. Cardiovasc Diabetol. 2019;18(1):27.PubMedPubMedCentralCrossRef
45.
go back to reference Clement KC, Suarez-Pierre A, Sebestyen K, Alejo D, DiNatale J, Whitman GJR, Matthew TL, Lawton JS. Increased glucose variability is associated with major adverse events after coronary artery bypass. Ann Thorac Surg. 2019;108(5):1307–13.PubMedCrossRef Clement KC, Suarez-Pierre A, Sebestyen K, Alejo D, DiNatale J, Whitman GJR, Matthew TL, Lawton JS. Increased glucose variability is associated with major adverse events after coronary artery bypass. Ann Thorac Surg. 2019;108(5):1307–13.PubMedCrossRef
46.
go back to reference Benalia M, Zeller M, Mouhat B, Guenancia C, Yameogo V, Greco C, Yao H, Maza M, Vergès B, Cottin Y. Glycaemic variability is associated with severity of coronary artery disease in patients with poorly controlled type 2 diabetes and acute myocardial infarction. Diabetes Metab. 2019;45(5):446–52.PubMedCrossRef Benalia M, Zeller M, Mouhat B, Guenancia C, Yameogo V, Greco C, Yao H, Maza M, Vergès B, Cottin Y. Glycaemic variability is associated with severity of coronary artery disease in patients with poorly controlled type 2 diabetes and acute myocardial infarction. Diabetes Metab. 2019;45(5):446–52.PubMedCrossRef
47.
go back to reference Ito T, Ichihashi T, Fujita H, Sugiura T, Yamamoto J, Kitada S, Nakasuka K, Kawada Y, Ohte N. The impact of intraday glucose variability on coronary artery spasm in patients with dysglycemia. Heart Vessels. 2019;34(8):1250–7.PubMedCrossRef Ito T, Ichihashi T, Fujita H, Sugiura T, Yamamoto J, Kitada S, Nakasuka K, Kawada Y, Ohte N. The impact of intraday glucose variability on coronary artery spasm in patients with dysglycemia. Heart Vessels. 2019;34(8):1250–7.PubMedCrossRef
48.
go back to reference Pu Z, Lai L, Yang X, Wang Y, Dong P, Wang D, Xie Y, Han Z. Acute glycemic variability on admission predicts the prognosis in hospitalized patients with coronary artery disease: a meta-analysis. Endocrine. 2020;67(3):526–34.PubMedCrossRef Pu Z, Lai L, Yang X, Wang Y, Dong P, Wang D, Xie Y, Han Z. Acute glycemic variability on admission predicts the prognosis in hospitalized patients with coronary artery disease: a meta-analysis. Endocrine. 2020;67(3):526–34.PubMedCrossRef
49.
go back to reference Nusca A, Tuccinardi D, Proscia C, Melfi R, Manfrini S, Nicolucci A, Ceriello A, Pozzilli P, Ussia GP, Grigioni F, et al. Incremental role of glycaemic variability over HbA1c in identifying type 2 diabetic patients with high platelet reactivity undergoing percutaneous coronary intervention. Cardiovasc Diabetol. 2019;18(1):147.PubMedPubMedCentralCrossRef Nusca A, Tuccinardi D, Proscia C, Melfi R, Manfrini S, Nicolucci A, Ceriello A, Pozzilli P, Ussia GP, Grigioni F, et al. Incremental role of glycaemic variability over HbA1c in identifying type 2 diabetic patients with high platelet reactivity undergoing percutaneous coronary intervention. Cardiovasc Diabetol. 2019;18(1):147.PubMedPubMedCentralCrossRef
50.
go back to reference Fuentes B, Pastor-Yborra S, Gutiérrez-Zúñiga R, González-Pérez de Villar N, de Rodríguez-Pardo CE, Gómez-de Frutos J, Laso-García MC, Gutiérrez-Fernández F, Ortega-Casarrubios M, et al. Glycemic variability: prognostic impact on acute ischemic stroke and the impact of corrective treatment for hyperglycemia. The GLIAS-III translational study. J Transl Med. 2020;18(1):414.PubMedPubMedCentralCrossRef Fuentes B, Pastor-Yborra S, Gutiérrez-Zúñiga R, González-Pérez de Villar N, de Rodríguez-Pardo CE, Gómez-de Frutos J, Laso-García MC, Gutiérrez-Fernández F, Ortega-Casarrubios M, et al. Glycemic variability: prognostic impact on acute ischemic stroke and the impact of corrective treatment for hyperglycemia. The GLIAS-III translational study. J Transl Med. 2020;18(1):414.PubMedPubMedCentralCrossRef
51.
go back to reference Gerbaud E, Darier R, Montaudon M, Beauvieux MC, Coffin-Boutreux C, Coste P, Douard H, Ouattara A, Catargi B. Glycemic variability is a powerful independent predictive factor of midterm major adverse cardiac events in patients with diabetes with acute coronary syndrome. Diabetes Care. 2019;42(4):674–81.PubMedCrossRef Gerbaud E, Darier R, Montaudon M, Beauvieux MC, Coffin-Boutreux C, Coste P, Douard H, Ouattara A, Catargi B. Glycemic variability is a powerful independent predictive factor of midterm major adverse cardiac events in patients with diabetes with acute coronary syndrome. Diabetes Care. 2019;42(4):674–81.PubMedCrossRef
52.
go back to reference Tang X, Zhong J, Zhang H, Luo Y, Liu X, Peng L, Zhang Y, Qian X, Jiang B, Liu J, et al. Visit-to-visit fasting plasma glucose variability is an important risk factor for long-term changes in left cardiac structure and function in patients with type 2 diabetes. Cardiovasc Diabetol. 2019;18(1):50.PubMedPubMedCentralCrossRef Tang X, Zhong J, Zhang H, Luo Y, Liu X, Peng L, Zhang Y, Qian X, Jiang B, Liu J, et al. Visit-to-visit fasting plasma glucose variability is an important risk factor for long-term changes in left cardiac structure and function in patients with type 2 diabetes. Cardiovasc Diabetol. 2019;18(1):50.PubMedPubMedCentralCrossRef
53.
go back to reference Bancks MP, Carson AP, Lewis CE, Gunderson EP, Reis JP, Schreiner PJ, Yano Y, Carnethon MR. Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality. Diabetologia. 2019;62(8):1366–74.PubMedPubMedCentralCrossRef Bancks MP, Carson AP, Lewis CE, Gunderson EP, Reis JP, Schreiner PJ, Yano Y, Carnethon MR. Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality. Diabetologia. 2019;62(8):1366–74.PubMedPubMedCentralCrossRef
54.
go back to reference Lee DY, Han K, Park S, Yu JH, Seo JA, Kim NH, Yoo HJ, Kim SG, Choi KM, Baik SH, et al. Glucose variability and the risks of stroke, myocardial infarction, and all-cause mortality in individuals with diabetes: retrospective cohort study. Cardiovasc Diabetol. 2020;19(1):144.PubMedPubMedCentralCrossRef Lee DY, Han K, Park S, Yu JH, Seo JA, Kim NH, Yoo HJ, Kim SG, Choi KM, Baik SH, et al. Glucose variability and the risks of stroke, myocardial infarction, and all-cause mortality in individuals with diabetes: retrospective cohort study. Cardiovasc Diabetol. 2020;19(1):144.PubMedPubMedCentralCrossRef
55.
go back to reference Yang CD, Shen Y, Ding FH, Yang ZK, Hu J, Shen WF, Zhang RY, Lu L, Wang XQ. Visit-to-visit fasting plasma glucose variability is associated with left ventricular adverse remodeling in diabetic patients with STEMI. Cardiovasc Diabetol. 2020;19(1):131.PubMedPubMedCentralCrossRef Yang CD, Shen Y, Ding FH, Yang ZK, Hu J, Shen WF, Zhang RY, Lu L, Wang XQ. Visit-to-visit fasting plasma glucose variability is associated with left ventricular adverse remodeling in diabetic patients with STEMI. Cardiovasc Diabetol. 2020;19(1):131.PubMedPubMedCentralCrossRef
56.
go back to reference Takao T, Matsuyama Y, Suka M, Yanagisawa H, Iwamoto Y. The combined effect of visit-to-visit variability in HbA1c and systolic blood pressure on the incidence of cardiovascular events in patients with type 2 diabetes. BMJ Open Diabetes Res Care. 2015;3(1):e000129.PubMedPubMedCentralCrossRef Takao T, Matsuyama Y, Suka M, Yanagisawa H, Iwamoto Y. The combined effect of visit-to-visit variability in HbA1c and systolic blood pressure on the incidence of cardiovascular events in patients with type 2 diabetes. BMJ Open Diabetes Res Care. 2015;3(1):e000129.PubMedPubMedCentralCrossRef
57.
go back to reference Mo Y, Zhou J, Ma X, Zhu W, Zhang L, Li J, Lu J, Hu C, Bao Y, Jia W. Haemoglobin A1c variability as an independent correlate of atherosclerosis and cardiovascular disease in Chinese type 2 diabetes. Diab Vasc Dis Res. 2018;15(5):402–8.PubMedCrossRef Mo Y, Zhou J, Ma X, Zhu W, Zhang L, Li J, Lu J, Hu C, Bao Y, Jia W. Haemoglobin A1c variability as an independent correlate of atherosclerosis and cardiovascular disease in Chinese type 2 diabetes. Diab Vasc Dis Res. 2018;15(5):402–8.PubMedCrossRef
58.
go back to reference Gu J, Fan YQ, Zhang JF, Wang CQ. Association of hemoglobin A1c variability and the incidence of heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus and arterial hypertension. Hellenic J Cardiol HJC Hellenike kardiologike epitheorese. 2018;59(2):91–7.PubMedCrossRef Gu J, Fan YQ, Zhang JF, Wang CQ. Association of hemoglobin A1c variability and the incidence of heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus and arterial hypertension. Hellenic J Cardiol HJC Hellenike kardiologike epitheorese. 2018;59(2):91–7.PubMedCrossRef
59.
go back to reference Gu J, Pan JA, Fan YQ, Zhang HL, Zhang JF, Wang CQ. Prognostic impact of HbA1c variability on long-term outcomes in patients with heart failure and type 2 diabetes mellitus. Cardiovasc Diabetol. 2018;17(1):96.PubMedPubMedCentralCrossRef Gu J, Pan JA, Fan YQ, Zhang HL, Zhang JF, Wang CQ. Prognostic impact of HbA1c variability on long-term outcomes in patients with heart failure and type 2 diabetes mellitus. Cardiovasc Diabetol. 2018;17(1):96.PubMedPubMedCentralCrossRef
60.
go back to reference Yokota S, Tanaka H, Mochizuki Y, Soga F, Yamashita K, Tanaka Y, Shono A, Suzuki M, Sumimoto K, Mukai J, et al. Association of glycemic variability with left ventricular diastolic function in type 2 diabetes mellitus. Cardiovasc Diabetol. 2019;18(1):166.PubMedPubMedCentralCrossRef Yokota S, Tanaka H, Mochizuki Y, Soga F, Yamashita K, Tanaka Y, Shono A, Suzuki M, Sumimoto K, Mukai J, et al. Association of glycemic variability with left ventricular diastolic function in type 2 diabetes mellitus. Cardiovasc Diabetol. 2019;18(1):166.PubMedPubMedCentralCrossRef
61.
go back to reference Yang CD, Shen Y, Lu L, Yang ZK, Hu J, Zhang RY, Shen WF, Ding FH, Wang XQ. Visit-to-visit HbA(1c) variability is associated with in-stent restenosis in patients with type 2 diabetes after percutaneous coronary intervention. Cardiovasc Diabetol. 2020;19(1):133.PubMedPubMedCentralCrossRef Yang CD, Shen Y, Lu L, Yang ZK, Hu J, Zhang RY, Shen WF, Ding FH, Wang XQ. Visit-to-visit HbA(1c) variability is associated with in-stent restenosis in patients with type 2 diabetes after percutaneous coronary intervention. Cardiovasc Diabetol. 2020;19(1):133.PubMedPubMedCentralCrossRef
62.
go back to reference Li S, Tang X, Luo Y, Wu B, Huang Z, Li Z, Peng L, Ling Y, Zhu J, Zhong J, et al. Impact of long-term glucose variability on coronary atherosclerosis progression in patients with type 2 diabetes: a 2.3 year follow-up study. Cardiovasc Diabetol. 2020;19(1):146.PubMedPubMedCentralCrossRef Li S, Tang X, Luo Y, Wu B, Huang Z, Li Z, Peng L, Ling Y, Zhu J, Zhong J, et al. Impact of long-term glucose variability on coronary atherosclerosis progression in patients with type 2 diabetes: a 2.3 year follow-up study. Cardiovasc Diabetol. 2020;19(1):146.PubMedPubMedCentralCrossRef
63.
go back to reference Yang CP, Lin CC, Li CI, Liu CS, Lin CH, Hwang KL, Yang SY, Li TC. Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes. Cardiovasc Diabetol. 2020;19(1):4.PubMedPubMedCentralCrossRef Yang CP, Lin CC, Li CI, Liu CS, Lin CH, Hwang KL, Yang SY, Li TC. Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes. Cardiovasc Diabetol. 2020;19(1):4.PubMedPubMedCentralCrossRef
64.
go back to reference Zhou JJ, Coleman R, Holman RR, Reaven P. Long-term glucose variability and risk of nephropathy complication in UKPDS, ACCORD and VADT trials. Diabetologia. 2020;63(11):2482–5.PubMedCrossRefPubMedCentral Zhou JJ, Coleman R, Holman RR, Reaven P. Long-term glucose variability and risk of nephropathy complication in UKPDS, ACCORD and VADT trials. Diabetologia. 2020;63(11):2482–5.PubMedCrossRefPubMedCentral
65.
go back to reference Ceriello A, De Cosmo S, Rossi MC, Lucisano G, Genovese S, Pontremoli R, Fioretto P, Giorda C, Pacilli A, Viazzi F, et al. Variability in HbA1c, blood pressure, lipid parameters and serum uric acid, and risk of development of chronic kidney disease in type 2 diabetes. Diabetes Obes Metab. 2017;19(11):1570–8.PubMedCrossRef Ceriello A, De Cosmo S, Rossi MC, Lucisano G, Genovese S, Pontremoli R, Fioretto P, Giorda C, Pacilli A, Viazzi F, et al. Variability in HbA1c, blood pressure, lipid parameters and serum uric acid, and risk of development of chronic kidney disease in type 2 diabetes. Diabetes Obes Metab. 2017;19(11):1570–8.PubMedCrossRef
66.
go back to reference Lee CL, Chen CH, Wu MJ, Tsai SF. The variability of glycated hemoglobin is associated with renal function decline in patients with type 2 diabetes. Ther Adv Chronic Dis. 2020;11:2040622319898370.PubMedPubMedCentral Lee CL, Chen CH, Wu MJ, Tsai SF. The variability of glycated hemoglobin is associated with renal function decline in patients with type 2 diabetes. Ther Adv Chronic Dis. 2020;11:2040622319898370.PubMedPubMedCentral
67.
go back to reference Viazzi F, Russo GT, Ceriello A, Fioretto P, Giorda C, De Cosmo S, Pontremoli R. Natural history and risk factors for diabetic kidney disease in patients with T2D: lessons from the AMD-annals. J Nephrol. 2019;32(4):517–25.PubMedCrossRef Viazzi F, Russo GT, Ceriello A, Fioretto P, Giorda C, De Cosmo S, Pontremoli R. Natural history and risk factors for diabetic kidney disease in patients with T2D: lessons from the AMD-annals. J Nephrol. 2019;32(4):517–25.PubMedCrossRef
68.
go back to reference Lee MY, Huang JC, Chen SC, Chiou HC, Wu PY. Association of HbA(1C) variability and renal progression in patients with type 2 diabetes with chronic kidney disease stages 3–4. Int J Mol Sci. 2018;19(12):4116.PubMedCentralCrossRef Lee MY, Huang JC, Chen SC, Chiou HC, Wu PY. Association of HbA(1C) variability and renal progression in patients with type 2 diabetes with chronic kidney disease stages 3–4. Int J Mol Sci. 2018;19(12):4116.PubMedCentralCrossRef
69.
go back to reference Song KH, Jeong JS, Kim MK, Kwon HS, Baek KH, Ko SH, Ahn YB. Discordance in risk factors for the progression of diabetic retinopathy and diabetic nephropathy in patients with type 2 diabetes mellitus. J Diabetes Investig. 2019;10(3):745–52.PubMedCrossRef Song KH, Jeong JS, Kim MK, Kwon HS, Baek KH, Ko SH, Ahn YB. Discordance in risk factors for the progression of diabetic retinopathy and diabetic nephropathy in patients with type 2 diabetes mellitus. J Diabetes Investig. 2019;10(3):745–52.PubMedCrossRef
70.
go back to reference Akaza M, Akaza I, Kanouchi T, Sasano T, Sumi Y, Yokota T. Nerve conduction study of the association between glycemic variability and diabetes neuropathy. Diabetol Metab Syndr. 2018;10:69.PubMedPubMedCentralCrossRef Akaza M, Akaza I, Kanouchi T, Sasano T, Sumi Y, Yokota T. Nerve conduction study of the association between glycemic variability and diabetes neuropathy. Diabetol Metab Syndr. 2018;10:69.PubMedPubMedCentralCrossRef
72.
go back to reference Pai YW, Lin CH, Lee IT, Chang MH. Variability of fasting plasma glucose and the risk of painful diabetic peripheral neuropathy in patients with type 2 diabetes. Diabetes Metab. 2018;44(2):129–34.PubMedCrossRef Pai YW, Lin CH, Lee IT, Chang MH. Variability of fasting plasma glucose and the risk of painful diabetic peripheral neuropathy in patients with type 2 diabetes. Diabetes Metab. 2018;44(2):129–34.PubMedCrossRef
73.
go back to reference Yang CP, Li CI, Liu CS, Lin WY, Hwang KL, Yang SY, Li TC, Lin CC. Variability of fasting plasma glucose increased risks of diabetic polyneuropathy in T2DM. Neurology. 2017;88(10):944–51.PubMedCrossRef Yang CP, Li CI, Liu CS, Lin WY, Hwang KL, Yang SY, Li TC, Lin CC. Variability of fasting plasma glucose increased risks of diabetic polyneuropathy in T2DM. Neurology. 2017;88(10):944–51.PubMedCrossRef
74.
go back to reference Su JB, Zhao LH, Zhang XL, Cai HL, Huang HY, Xu F, Chen T, Wang XQ. HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients. Cardiovasc Diabetol. 2018;17(1):47.PubMedPubMedCentralCrossRef Su JB, Zhao LH, Zhang XL, Cai HL, Huang HY, Xu F, Chen T, Wang XQ. HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients. Cardiovasc Diabetol. 2018;17(1):47.PubMedPubMedCentralCrossRef
75.
go back to reference Lai YR, Huang CC, Chiu WC, Liu RT, Tsai NW, Wang HC, Lin WC, Cheng BC, Su YJ, Su CM, et al. HbA1C variability is strongly associated with the severity of cardiovascular autonomic neuropathy in patients with type 2 diabetes after longer diabetes duration. Front NeuroSci. 2019;13:458.PubMedPubMedCentralCrossRef Lai YR, Huang CC, Chiu WC, Liu RT, Tsai NW, Wang HC, Lin WC, Cheng BC, Su YJ, Su CM, et al. HbA1C variability is strongly associated with the severity of cardiovascular autonomic neuropathy in patients with type 2 diabetes after longer diabetes duration. Front NeuroSci. 2019;13:458.PubMedPubMedCentralCrossRef
76.
go back to reference Lai YR, Chiu WC, Huang CC, Tsai NW, Wang HC, Lin WC, Cheng BC, Su YJ, Su CM, Hsiao SY, et al. HbA1C variability is strongly associated with the severity of peripheral neuropathy in patients with type 2 diabetes. Front NeuroSci. 2019;13:90.PubMedPubMedCentralCrossRef Lai YR, Chiu WC, Huang CC, Tsai NW, Wang HC, Lin WC, Cheng BC, Su YJ, Su CM, Hsiao SY, et al. HbA1C variability is strongly associated with the severity of peripheral neuropathy in patients with type 2 diabetes. Front NeuroSci. 2019;13:90.PubMedPubMedCentralCrossRef
77.
go back to reference Christensen MMB, Hommel EE, Jørgensen ME, Fleischer J, Hansen CS. Glycemic variability and diabetic neuropathy in young adults with type 1 diabetes. Front Endocrinol. 2020;11:644.CrossRef Christensen MMB, Hommel EE, Jørgensen ME, Fleischer J, Hansen CS. Glycemic variability and diabetic neuropathy in young adults with type 1 diabetes. Front Endocrinol. 2020;11:644.CrossRef
78.
go back to reference Lu J, Ma X, Zhou J, Zhang L, Mo Y, Ying L, Lu W, Zhu W, Bao Y, Vigersky RA, et al. Association of time in range, as assessed by continuous glucose monitoring, with diabetic retinopathy in type 2 diabetes. Diabetes Care. 2018;41(11):2370–6.PubMedCrossRef Lu J, Ma X, Zhou J, Zhang L, Mo Y, Ying L, Lu W, Zhu W, Bao Y, Vigersky RA, et al. Association of time in range, as assessed by continuous glucose monitoring, with diabetic retinopathy in type 2 diabetes. Diabetes Care. 2018;41(11):2370–6.PubMedCrossRef
79.
go back to reference Zhao Q, Zhou F, Zhang Y, Zhou X, Ying C. Fasting plasma glucose variability levels and risk of adverse outcomes among patients with type 2 diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2019;148:23–31.PubMedCrossRef Zhao Q, Zhou F, Zhang Y, Zhou X, Ying C. Fasting plasma glucose variability levels and risk of adverse outcomes among patients with type 2 diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2019;148:23–31.PubMedCrossRef
80.
go back to reference Rosa L, Zajdenverg L, Souto DL, Dantas JR, Pinto MVR, Salles G, Rodacki M. HbA1c variability and long-term glycemic control are linked to diabetic retinopathy and glomerular filtration rate in patients with type 1 diabetes and multiethnic background. J Diabetes Complicat. 2019;33(9):610–5.CrossRef Rosa L, Zajdenverg L, Souto DL, Dantas JR, Pinto MVR, Salles G, Rodacki M. HbA1c variability and long-term glycemic control are linked to diabetic retinopathy and glomerular filtration rate in patients with type 1 diabetes and multiethnic background. J Diabetes Complicat. 2019;33(9):610–5.CrossRef
81.
go back to reference Schreur V, van Asten F, Ng H, Weeda J, Groenewoud JMM, Tack CJ, Hoyng CB, de Jong EK, Klaver CCW, Jeroen Klevering B. Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus. Acta Ophthalmol. 2018;96(5):459–64.PubMedPubMedCentralCrossRef Schreur V, van Asten F, Ng H, Weeda J, Groenewoud JMM, Tack CJ, Hoyng CB, de Jong EK, Klaver CCW, Jeroen Klevering B. Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus. Acta Ophthalmol. 2018;96(5):459–64.PubMedPubMedCentralCrossRef
82.
go back to reference Rama Chandran S, Tay WL, Lye WK, Lim LL, Ratnasingam J, Tan ATB, Gardner DSL. Beyond HbA1c: comparing glycemic variability and glycemic indices in predicting hypoglycemia in type 1 and type 2 diabetes. Diabetes Technol Ther. 2018;20(5):353–62.PubMedCrossRef Rama Chandran S, Tay WL, Lye WK, Lim LL, Ratnasingam J, Tan ATB, Gardner DSL. Beyond HbA1c: comparing glycemic variability and glycemic indices in predicting hypoglycemia in type 1 and type 2 diabetes. Diabetes Technol Ther. 2018;20(5):353–62.PubMedCrossRef
83.
go back to reference Gómez AM, Muñoz OM, Marin A, Fonseca MC, Rondon M, Robledo Gómez MA, Sanko A, Lujan D, García-Jaramillo M, León Vargas FM. Different indexes of glycemic variability as identifiers of patients with risk of hypoglycemia in type 2 diabetes mellitus. J Diabetes Sci Technol. 2018;12(5):1007–15.PubMedPubMedCentralCrossRef Gómez AM, Muñoz OM, Marin A, Fonseca MC, Rondon M, Robledo Gómez MA, Sanko A, Lujan D, García-Jaramillo M, León Vargas FM. Different indexes of glycemic variability as identifiers of patients with risk of hypoglycemia in type 2 diabetes mellitus. J Diabetes Sci Technol. 2018;12(5):1007–15.PubMedPubMedCentralCrossRef
84.
go back to reference Gómez AM, Henao DC, Imitola Madero A, Taboada LB, Cruz V, Robledo Gómez MA, Rondón M, Muñoz-Velandia O, García-Jaramillo M, León Vargas FM. Defining high glycemic variability in type 1 diabetes: comparison of multiple indexes to identify patients at risk of hypoglycemia. Diabetes Technol Ther. 2019;21(8):430–9.PubMedCrossRef Gómez AM, Henao DC, Imitola Madero A, Taboada LB, Cruz V, Robledo Gómez MA, Rondón M, Muñoz-Velandia O, García-Jaramillo M, León Vargas FM. Defining high glycemic variability in type 1 diabetes: comparison of multiple indexes to identify patients at risk of hypoglycemia. Diabetes Technol Ther. 2019;21(8):430–9.PubMedCrossRef
85.
go back to reference Valente T, Arbex AK. Glycemic variability, oxidative stress and impact on complications related to type 2 diabetes mellitus. Curr Diabetes Rev. 2020;771:139–54. Valente T, Arbex AK. Glycemic variability, oxidative stress and impact on complications related to type 2 diabetes mellitus. Curr Diabetes Rev. 2020;771:139–54.
86.
go back to reference Papachristoforou E, Lambadiari V, Maratou E, Makrilakis K. Association of glycemic indices (hyperglycemia, glucose variability, and hypoglycemia) with oxidative stress and diabetic complications. J Diabetes Res. 2020;2020:7489795.PubMedPubMedCentralCrossRef Papachristoforou E, Lambadiari V, Maratou E, Makrilakis K. Association of glycemic indices (hyperglycemia, glucose variability, and hypoglycemia) with oxidative stress and diabetic complications. J Diabetes Res. 2020;2020:7489795.PubMedPubMedCentralCrossRef
87.
go back to reference Ceriello A, Esposito K, Piconi L, Ihnat MA, Thorpe JE, Testa R, Boemi M, Giugliano D. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes. 2008;57(5):1349–54.PubMedCrossRef Ceriello A, Esposito K, Piconi L, Ihnat MA, Thorpe JE, Testa R, Boemi M, Giugliano D. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes. 2008;57(5):1349–54.PubMedCrossRef
88.
go back to reference Quagliaro L, Piconi L, Assaloni R, Martinelli L, Motz E, Ceriello A. Intermittent high glucose enhances apoptosis related to oxidative stress in human umbilical vein endothelial cells: the role of protein kinase C and NAD(P)H-oxidase activation. Diabetes. 2003;52(11):2795–804.PubMedCrossRef Quagliaro L, Piconi L, Assaloni R, Martinelli L, Motz E, Ceriello A. Intermittent high glucose enhances apoptosis related to oxidative stress in human umbilical vein endothelial cells: the role of protein kinase C and NAD(P)H-oxidase activation. Diabetes. 2003;52(11):2795–804.PubMedCrossRef
89.
go back to reference Schisano B, Tripathi G, McGee K, McTernan PG, Ceriello A. Glucose oscillations, more than constant high glucose, induce p53 activation and a metabolic memory in human endothelial cells. Diabetologia. 2011;54(5):1219–26.PubMedCrossRef Schisano B, Tripathi G, McGee K, McTernan PG, Ceriello A. Glucose oscillations, more than constant high glucose, induce p53 activation and a metabolic memory in human endothelial cells. Diabetologia. 2011;54(5):1219–26.PubMedCrossRef
90.
go back to reference Keating ST, El-Osta A. Glycemic memories and the epigenetic component of diabetic nephropathy. Curr Diabetes Rep. 2013;13(4):574–81.CrossRef Keating ST, El-Osta A. Glycemic memories and the epigenetic component of diabetic nephropathy. Curr Diabetes Rep. 2013;13(4):574–81.CrossRef
91.
go back to reference Groop PH, Forsblom C, Thomas MC. Mechanisms of disease: pathway-selective insulin resistance and microvascular complications of diabetes. Nat Clin Pract Endocrinol Metab. 2005;1(2):100–10.PubMedCrossRef Groop PH, Forsblom C, Thomas MC. Mechanisms of disease: pathway-selective insulin resistance and microvascular complications of diabetes. Nat Clin Pract Endocrinol Metab. 2005;1(2):100–10.PubMedCrossRef
92.
go back to reference Del Guerra S, Grupillo M, Masini M, Lupi R, Bugliani M, Torri S, Boggi U, Del Chiaro M, Vistoli F, Mosca F, et al. Gliclazide protects human islet beta-cells from apoptosis induced by intermittent high glucose. Diabetes Metab Res Rev. 2007;23(3):234–8.PubMedCrossRef Del Guerra S, Grupillo M, Masini M, Lupi R, Bugliani M, Torri S, Boggi U, Del Chiaro M, Vistoli F, Mosca F, et al. Gliclazide protects human islet beta-cells from apoptosis induced by intermittent high glucose. Diabetes Metab Res Rev. 2007;23(3):234–8.PubMedCrossRef
93.
go back to reference Costantino S, Paneni F, Battista R, Castello L, Capretti G, Chiandotto S, Tanese L, Russo G, Pitocco D, Lanza GA, et al. Impact of glycemic variability on chromatin remodeling, oxidative stress, and endothelial dysfunction in patients with type 2 diabetes and with target HbA(1c) levels. Diabetes. 2017;66(9):2472–82.PubMedCrossRef Costantino S, Paneni F, Battista R, Castello L, Capretti G, Chiandotto S, Tanese L, Russo G, Pitocco D, Lanza GA, et al. Impact of glycemic variability on chromatin remodeling, oxidative stress, and endothelial dysfunction in patients with type 2 diabetes and with target HbA(1c) levels. Diabetes. 2017;66(9):2472–82.PubMedCrossRef
94.
go back to reference Ceriello A, Esposito K, Piconi L, Ihnat M, Thorpe J, Testa R, Bonfigli AR, Giugliano D. Glucose “peak” and glucose “spike”: impact on endothelial function and oxidative stress. Diabetes Res Clin Pract. 2008;82(2):262–7.PubMedCrossRef Ceriello A, Esposito K, Piconi L, Ihnat M, Thorpe J, Testa R, Bonfigli AR, Giugliano D. Glucose “peak” and glucose “spike”: impact on endothelial function and oxidative stress. Diabetes Res Clin Pract. 2008;82(2):262–7.PubMedCrossRef
95.
go back to reference Brownlee M, Hirsch IB. Glycemic variability: a hemoglobin A1c-independent risk factor for diabetic complications. JAMA. 2006;295(14):1707–8.PubMedCrossRef Brownlee M, Hirsch IB. Glycemic variability: a hemoglobin A1c-independent risk factor for diabetic complications. JAMA. 2006;295(14):1707–8.PubMedCrossRef
96.
go back to reference Monnier L, Mas E, Ginet C, Michel F, Villon L, Cristol JP, Colette C. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA. 2006;295(14):1681–7.PubMedCrossRef Monnier L, Mas E, Ginet C, Michel F, Villon L, Cristol JP, Colette C. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA. 2006;295(14):1681–7.PubMedCrossRef
97.
98.
go back to reference Di Flaviani A, Picconi F, Di Stefano P, Giordani I, Malandrucco I, Maggio P, Palazzo P, Sgreccia F, Peraldo C, Farina F, et al. Impact of glycemic and blood pressure variability on surrogate measures of cardiovascular outcomes in type 2 diabetic patients. Diabetes Care. 2011;34(7):1605–9.PubMedPubMedCentralCrossRef Di Flaviani A, Picconi F, Di Stefano P, Giordani I, Malandrucco I, Maggio P, Palazzo P, Sgreccia F, Peraldo C, Farina F, et al. Impact of glycemic and blood pressure variability on surrogate measures of cardiovascular outcomes in type 2 diabetic patients. Diabetes Care. 2011;34(7):1605–9.PubMedPubMedCentralCrossRef
99.
go back to reference Siegelaar SE, Barwari T, Kulik W, Hoekstra JB, DeVries JH. No relevant relationship between glucose variability and oxidative stress in well-regulated type 2 diabetes patients. J Diabetes Sci Technol. 2011;5(1):86–92.PubMedPubMedCentralCrossRef Siegelaar SE, Barwari T, Kulik W, Hoekstra JB, DeVries JH. No relevant relationship between glucose variability and oxidative stress in well-regulated type 2 diabetes patients. J Diabetes Sci Technol. 2011;5(1):86–92.PubMedPubMedCentralCrossRef
100.
go back to reference Wentholt IM, Kulik W, Michels RP, Hoekstra JB, DeVries JH. Glucose fluctuations and activation of oxidative stress in patients with type 1 diabetes. Diabetologia. 2008;51(1):183–90.PubMedCrossRef Wentholt IM, Kulik W, Michels RP, Hoekstra JB, DeVries JH. Glucose fluctuations and activation of oxidative stress in patients with type 1 diabetes. Diabetologia. 2008;51(1):183–90.PubMedCrossRef
101.
go back to reference Ratter JM, Rooijackers HM, Tack CJ, Hijmans AG, Netea MG, de Galan BE, Stienstra R. Proinflammatory effects of hypoglycemia in humans with or without diabetes. Diabetes. 2017;66(4):1052–61.PubMedCrossRef Ratter JM, Rooijackers HM, Tack CJ, Hijmans AG, Netea MG, de Galan BE, Stienstra R. Proinflammatory effects of hypoglycemia in humans with or without diabetes. Diabetes. 2017;66(4):1052–61.PubMedCrossRef
102.
go back to reference Gogitidze Joy N, Hedrington MS, Briscoe VJ, Tate DB, Ertl AC, Davis SN. Effects of acute hypoglycemia on inflammatory and pro-atherothrombotic biomarkers in individuals with type 1 diabetes and healthy individuals. Diabetes Care. 2010;33(7):1529–35.PubMedPubMedCentralCrossRef Gogitidze Joy N, Hedrington MS, Briscoe VJ, Tate DB, Ertl AC, Davis SN. Effects of acute hypoglycemia on inflammatory and pro-atherothrombotic biomarkers in individuals with type 1 diabetes and healthy individuals. Diabetes Care. 2010;33(7):1529–35.PubMedPubMedCentralCrossRef
103.
go back to reference Rodbard D. Continuous glucose monitoring: a review of recent studies demonstrating improved glycemic outcomes. Diabetes Technol Ther. 2017;19(S3):25-s37.CrossRef Rodbard D. Continuous glucose monitoring: a review of recent studies demonstrating improved glycemic outcomes. Diabetes Technol Ther. 2017;19(S3):25-s37.CrossRef
104.
go back to reference Avari P, Moscardo V, Jugnee N, Oliver N, Reddy M. Glycemic variability and hypoglycemic excursions with continuous glucose monitoring compared to intermittently scanned continuous glucose monitoring in adults with highest risk type 1 diabetes. J Diabetes Sci Technol. 2020;14(3):567–74.PubMedCrossRef Avari P, Moscardo V, Jugnee N, Oliver N, Reddy M. Glycemic variability and hypoglycemic excursions with continuous glucose monitoring compared to intermittently scanned continuous glucose monitoring in adults with highest risk type 1 diabetes. J Diabetes Sci Technol. 2020;14(3):567–74.PubMedCrossRef
105.
go back to reference Maiorino MI, Signoriello S, Maio A, Chiodini P, Bellastella G, Scappaticcio L, Longo M, Giugliano D, Esposito K. Effects of continuous glucose monitoring on metrics of glycemic control in diabetes: a systematic review with meta-analysis of randomized controlled trials. Diabetes Care. 2020;43(5):1146–56.PubMedCrossRef Maiorino MI, Signoriello S, Maio A, Chiodini P, Bellastella G, Scappaticcio L, Longo M, Giugliano D, Esposito K. Effects of continuous glucose monitoring on metrics of glycemic control in diabetes: a systematic review with meta-analysis of randomized controlled trials. Diabetes Care. 2020;43(5):1146–56.PubMedCrossRef
106.
go back to reference Figueira FR, Umpierre D, Casali KR, Tetelbom PS, Henn NT, Ribeiro JP, Schaan BD. Aerobic and combined exercise sessions reduce glucose variability in type 2 diabetes: crossover randomized trial. PLoS ONE. 2013;8(3):e57733.PubMedPubMedCentralCrossRef Figueira FR, Umpierre D, Casali KR, Tetelbom PS, Henn NT, Ribeiro JP, Schaan BD. Aerobic and combined exercise sessions reduce glucose variability in type 2 diabetes: crossover randomized trial. PLoS ONE. 2013;8(3):e57733.PubMedPubMedCentralCrossRef
107.
go back to reference Farabi SS, Carley DW, Smith D, Quinn L. Impact of exercise on diurnal and nocturnal markers of glycaemic variability and oxidative stress in obese individuals with type 2 diabetes or impaired glucose tolerance. Diab Vasc Dis Res. 2015;12(5):381–5.PubMedCrossRef Farabi SS, Carley DW, Smith D, Quinn L. Impact of exercise on diurnal and nocturnal markers of glycaemic variability and oxidative stress in obese individuals with type 2 diabetes or impaired glucose tolerance. Diab Vasc Dis Res. 2015;12(5):381–5.PubMedCrossRef
108.
go back to reference Rafiei H, Robinson E, Barry J, Jung ME, Little JP. Short-term exercise training reduces glycaemic variability and lowers circulating endothelial microparticles in overweight and obese women at elevated risk of type 2 diabetes. Eur J Sport Sci. 2019;19(8):1140–9.PubMedCrossRef Rafiei H, Robinson E, Barry J, Jung ME, Little JP. Short-term exercise training reduces glycaemic variability and lowers circulating endothelial microparticles in overweight and obese women at elevated risk of type 2 diabetes. Eur J Sport Sci. 2019;19(8):1140–9.PubMedCrossRef
109.
go back to reference Figueira FR, Umpierre D, Bock PM, Waclawovsky G, Guerra AP, Donelli A, Andrades M, Casali KR, Schaan BD. Effect of exercise on glucose variability in healthy subjects: randomized crossover trial. Biol Sport. 2019;36(2):141–8.PubMedPubMedCentralCrossRef Figueira FR, Umpierre D, Bock PM, Waclawovsky G, Guerra AP, Donelli A, Andrades M, Casali KR, Schaan BD. Effect of exercise on glucose variability in healthy subjects: randomized crossover trial. Biol Sport. 2019;36(2):141–8.PubMedPubMedCentralCrossRef
110.
go back to reference Ranjan A, Schmidt S, Damm-Frydenberg C, Holst JJ, Madsbad S, Nørgaard K. Short-term effects of a low carbohydrate diet on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes: a randomized open-label crossover trial. Diabetes Obes Metab. 2017;19(10):1479–84.PubMedCrossRef Ranjan A, Schmidt S, Damm-Frydenberg C, Holst JJ, Madsbad S, Nørgaard K. Short-term effects of a low carbohydrate diet on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes: a randomized open-label crossover trial. Diabetes Obes Metab. 2017;19(10):1479–84.PubMedCrossRef
111.
go back to reference Ahola AJ, Forsblom C, Harjutsalo V, Groop PH. Dietary carbohydrate intake and cardio-metabolic risk factors in type 1 diabetes. Diabetes Res Clin Pract. 2019;155:107818.PubMedCrossRef Ahola AJ, Forsblom C, Harjutsalo V, Groop PH. Dietary carbohydrate intake and cardio-metabolic risk factors in type 1 diabetes. Diabetes Res Clin Pract. 2019;155:107818.PubMedCrossRef
113.
go back to reference Chang CR, Francois ME, Little JP. Restricting carbohydrates at breakfast is sufficient to reduce 24-hour exposure to postprandial hyperglycemia and improve glycemic variability. Am J Clin Nutr. 2019;109(5):1302–9.PubMedPubMedCentralCrossRef Chang CR, Francois ME, Little JP. Restricting carbohydrates at breakfast is sufficient to reduce 24-hour exposure to postprandial hyperglycemia and improve glycemic variability. Am J Clin Nutr. 2019;109(5):1302–9.PubMedPubMedCentralCrossRef
114.
go back to reference Nishimura R, Osonoi T, Koike Y, Miyata K, Shimasaki Y. A randomized pilot study of the effect of trelagliptin and alogliptin on glycemic variability in patients with type 2 diabetes. Adv Ther. 2019;36(11):3096–109.PubMedPubMedCentralCrossRef Nishimura R, Osonoi T, Koike Y, Miyata K, Shimasaki Y. A randomized pilot study of the effect of trelagliptin and alogliptin on glycemic variability in patients with type 2 diabetes. Adv Ther. 2019;36(11):3096–109.PubMedPubMedCentralCrossRef
115.
go back to reference Bajaj HS, Venn K, Ye C, Patrick A, Kalra S, Khandwala H, Aslam N, Twum-Barima D, Aronson R. Lowest glucose variability and hypoglycemia are observed with the combination of a GLP-1 receptor agonist and basal insulin (VARIATION study). Diabetes Care. 2017;40(2):194–200.PubMedCrossRef Bajaj HS, Venn K, Ye C, Patrick A, Kalra S, Khandwala H, Aslam N, Twum-Barima D, Aronson R. Lowest glucose variability and hypoglycemia are observed with the combination of a GLP-1 receptor agonist and basal insulin (VARIATION study). Diabetes Care. 2017;40(2):194–200.PubMedCrossRef
116.
go back to reference Park SE, Lee BW, Kim JH, Lee WJ, Cho JH, Jung CH, Lee SH, Suh S, Hur GC, Kim SH, et al. Effect of gemigliptin on glycaemic variability in patients with type 2 diabetes (STABLE study). Diabetes Obes Metab. 2017;19(6):892–6.PubMedCrossRef Park SE, Lee BW, Kim JH, Lee WJ, Cho JH, Jung CH, Lee SH, Suh S, Hur GC, Kim SH, et al. Effect of gemigliptin on glycaemic variability in patients with type 2 diabetes (STABLE study). Diabetes Obes Metab. 2017;19(6):892–6.PubMedCrossRef
117.
go back to reference Kim NH, Kim DL, Kim KJ, Kim NH, Choi KM, Baik SH, Kim SG. Effects of vildagliptin or pioglitazone on glycemic variability and oxidative stress in patients with type 2 diabetes inadequately controlled with metformin monotherapy: a 16-week, randomised, open label, pilot study. Endocrinol Metab (Seoul Korea). 2017;32(2):241–7.CrossRef Kim NH, Kim DL, Kim KJ, Kim NH, Choi KM, Baik SH, Kim SG. Effects of vildagliptin or pioglitazone on glycemic variability and oxidative stress in patients with type 2 diabetes inadequately controlled with metformin monotherapy: a 16-week, randomised, open label, pilot study. Endocrinol Metab (Seoul Korea). 2017;32(2):241–7.CrossRef
118.
go back to reference Kim G, Oh S, Jin SM, Hur KY, Kim JH, Lee MK. The efficacy and safety of adding either vildagliptin or glimepiride to ongoing metformin therapy in patients with type 2 diabetes mellitus. Expert Opin Pharmacother. 2017;18(12):1179–86.PubMedCrossRef Kim G, Oh S, Jin SM, Hur KY, Kim JH, Lee MK. The efficacy and safety of adding either vildagliptin or glimepiride to ongoing metformin therapy in patients with type 2 diabetes mellitus. Expert Opin Pharmacother. 2017;18(12):1179–86.PubMedCrossRef
119.
go back to reference Al-Kuraishy HM, Sami OM, Hussain NR, Al-Gareeb AI. Metformin and/or vildagliptin mitigate type II diabetes mellitus induced-oxidative stress: the intriguing effect. J Adv Pharm Tech Res. 2020;11(3):142–7.CrossRef Al-Kuraishy HM, Sami OM, Hussain NR, Al-Gareeb AI. Metformin and/or vildagliptin mitigate type II diabetes mellitus induced-oxidative stress: the intriguing effect. J Adv Pharm Tech Res. 2020;11(3):142–7.CrossRef
120.
go back to reference Famulla S, Pieber TR, Eilbracht J, Neubacher D, Soleymanlou N, Woerle HJ, Broedl UC, Kaspers S. Glucose Exposure and Variability with Empagliflozin as Adjunct to Insulin in Patients with Type 1 Diabetes: Continuous Glucose Monitoring Data from a 4-Week, Randomized, Placebo-Controlled Trial (EASE-1). Diabetes Technol Ther. 2017;19(1):49–60.PubMedCrossRef Famulla S, Pieber TR, Eilbracht J, Neubacher D, Soleymanlou N, Woerle HJ, Broedl UC, Kaspers S. Glucose Exposure and Variability with Empagliflozin as Adjunct to Insulin in Patients with Type 1 Diabetes: Continuous Glucose Monitoring Data from a 4-Week, Randomized, Placebo-Controlled Trial (EASE-1). Diabetes Technol Ther. 2017;19(1):49–60.PubMedCrossRef
121.
go back to reference Suzuki D, Yamada H, Yoshida M, Funazaki S, Amamoto M, Morimoto J, Hara K. Sodium-glucose cotransporter 2 inhibitors improved time-in-range without increasing hypoglycemia in Japanese patients with type 1 diabetes: a retrospective, single-center, pilot study. J Diabetes Investig. 2020;11(5):1230–7.PubMedPubMedCentralCrossRef Suzuki D, Yamada H, Yoshida M, Funazaki S, Amamoto M, Morimoto J, Hara K. Sodium-glucose cotransporter 2 inhibitors improved time-in-range without increasing hypoglycemia in Japanese patients with type 1 diabetes: a retrospective, single-center, pilot study. J Diabetes Investig. 2020;11(5):1230–7.PubMedPubMedCentralCrossRef
Metadata
Title
Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications
Authors
Bao Sun
Zhiying Luo
Jiecan Zhou
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2021
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-020-01200-7

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