Type 2 Diabetes and Glycemic Variability: Various Parameters in Clinical Practice

Abstract

It has become possible to measure blood glucose levels continuously from 24 h to approximately 2 weeks due to the recent development of relevant devices such as continuous glucose monitoring and flash glucose monitoring systems. This has enabled not only medical professionals but also patients to monitor details of glycemic variability (GV) which was not possible in the past. Details of GV for both short and intermediate periods can now be obtained, and it is important in patient care to appropriately evaluate the data obtained. Types of GV in terms of time frame vary from short-term to long-term. Several studies reported that long-term GV was related to micro- and macro-angiopathies in patients with type 2 diabetes mellitus (T2DM). However, there are still unknown aspects regarding the relationships of various durations of GV with prognosis. Further clinical trials are required to examine the mechanism of GV and to evaluate whether GV can be a valuable therapeutic target in treatment of patients with T2DM.

Glycemic variability and subsequent malignancies among the population without diabetes

“…Finally, use of long-term (visit-to-visit) glycemic variability may be more persuasive for the relationship. It has been said that long-term glycemic variability showed more evidence regarding the prognosis of diabetes compared to short-term glycemic variability, such as using continuous glucose monitoring [33]. This evidence may support our finding and make our results more reliable.…”

A View Beyond HbA1c: Role of Continuous Glucose Monitoring

“…Many factors affect GV in patients, including lifestyle [ 43 ], diet, the presence of comorbidities, diabetes treatment [ 44 ], and even insulin injection technique [ 45 ]. The best method by which to assess GV is still a matter of debate.…”

Capturing glucose variability in patients with diabetes

“…However, in addition to this valuable clinical utility, the wider application of CGM, together with a fresh appreciation of the role of glucose variability in glycaemic control, may have much to contribute to the prevention of complications in both type 1 and type 2 diabetes (see Table 3). 33‐38 …”