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

• Published in: Diabetes research and clinical practice 2014-09, Vol.105 (3), p.273-284
• Main Authors: Smith-Palmer, J, Brändle, M, Trevisan, R, Orsini Federici, M, Liabat, S, Valentine, W
• Format: Article
• Language: English
• Subjects: Blood Glucose - analysis; Blood Glucose - metabolism; Coronary Artery Disease - etiology; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetic Nephropathies - etiology; Diabetic Retinopathy - etiology; Endocrinology & Metabolism; Female; Glycemic variability; Humans; Hyperglycemia - complications; Macrovascular complications; Male; Microvascular complications; Oxidative Stress; Risk Factors
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2014.06.007

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.