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Glycemic variability: Clinical implications

Surabhi Venkata Satya Krishna1, Sunil K Kota, Kirtikumar D Modi

  • 1Department of Endocrinology, Medwin Hospital, Hyderabad, Andhra Pradesh, India.

Indian Journal of Endocrinology and Metabolism
|August 21, 2013
PubMed

Insights

Glycemic variability (GV) is linked to cardiovascular risk in diabetes. Minimizing GV, alongside other glycemic measures, may help prevent cardiovascular events in Type 2 diabetes patients.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Cardiovascular Research

Background:

  • Prospective trials confirm glycemic control prevents microvascular diabetic complications.
  • The Diabetes Control and Complications Trial (DCCT) linked variable glycated hemoglobin (HbA1C) to increased microvascular issues.
  • The direct link between glycemic variability and macrovascular complications remains under investigation.

Purpose of the Study:

  • To explore the role of glycemic variability (GV) in cardiovascular risk among diabetic patients.
  • To highlight GV as a crucial factor in diabetes management, alongside fasting blood sugar, postprandial blood sugar, HbA1C, and quality of life (the glycemic pentad).
  • To discuss the mechanisms, clinical implications, and control strategies for GV.

Main Methods:

  • Review of existing literature on glycemic control, variability, and cardiovascular events in diabetes.
  • Analysis of the proposed 'glycemic pentad' for comprehensive diabetes management.
  • Discussion of modern therapeutic approaches addressing GV.

Main Results:

  • Glycemic variability (GV), encompassing postprandial spikes and hypoglycemia, is implicated in increased cardiovascular events in Type 2 diabetes.
  • Minimizing GV is proposed as a strategy to prevent future cardiovascular events.
  • Modern diabetes management strategies effectively address GV.

Conclusions:

  • Glycemic variability is a significant factor contributing to cardiovascular risk in diabetic patients.
  • Comprehensive diabetes management should consider GV alongside other glycemic parameters.
  • Current therapeutic advancements offer effective means to control GV and potentially mitigate cardiovascular risks.

Keywords:
Diabetes mellitusglycemic variabilityincretinsoxidative stress

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