Impact of HbA1c variability on subclinical left ventricular remodeling and dysfunction in patients with type 2 diabetes mellitus

Sleep Apnea and Diabetes Predict Progression of Cardiac Diastolic Dysfunction in Pre-heart Failure Patients: a Prospective Cohort HSCAA Study

“…A previous study showed that even in a population with normal glucose tolerance, a parameter of diastolic dysfunction was inversely associated with HbA1c [20]. Although variations of HbA1c may be serve as predictors of changes in E/e' [21], in the present cohort, HbA1c was not a major predictor of annual change in E/e'. In a prior cross-sectional study, glycemic variability, determined by continuous glucose monitoring, was also shown to be associated with left ventricular diastolic function in type 2 diabetes mellitus subjects [22].…”

Impact of long-term glucose variability on coronary atherosclerosis progression in patients with type 2 diabetes: a 2.3 year follow-up study

“…The present study provides further evidence that long-term GV is independently associated with coronary plaque progression before the occurrence of clinical cardiovascular events. This may partly explain the finding of our previous studies, which demonstrated that GV was a novel risk factor for both the long-term adverse changes in cardiac function [ 9 , 10 ] and 10-year risk of CVD in patients with T2DM [ 8 ]. Our findings suggest that maintaining long-term glycemic stability for patients with T2DM may delay the progression of CAD and improve clinical outcomes.…”

“…In patients with T2DM, an abundant of evidence has indicated that glycemic variability (GV), independent of hyperglycemia, is associated with an increased risk of cardiovascular diseases [ 8 ], adverse changes of cardiac structure and function [ 9 , 10 ], ischemic stroke [ 11 ], cardiovascular mortality [ 12 ], all-cause mortality [ 13 – 16 ], and coronary plaque vulnerability [ 17 – 21 ]. However, little is known about the impact of GV on coronary plaque progression in patients with T2DM.…”

Comparative predictive ability of visit-to-visit HbA1c variability measures for microvascular disease risk in type 2 diabetes

“…In patients with type 1 diabetes, HbA1c variability was found as an important risk factor for vascular complications such as cardiovascular diseases (CVDs) [8], microvascular diseases (MVDs) [8][9][10][11], and hospitalized hypoglycemia [12]. In patients with type 2 diabetes, although cumulative evidence shows the predictive role of HbA1c variability in the risks of hypoglycemia [12], CVDs [13][14][15][16][17][18][19][20] (such as subclinical left ventricular remodeling and dysfunction [21], reduced baroreflex sensitivity [22], and high thrombotic risk [23]), and allcause mortality [15][16][17][18][19][20][24][25][26][27][28][29][30], studies on MVDs [15,19,22,[31][32][33][34][35][36][37] are relatively limited and yield inconsistent results [34][35][36].…”