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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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Glucose variability, HbA1c and microvascular complications.

Jan Škrha1, Jan Šoupal2, Jan Škrha2

  • 13rd Department of Internal Medicine, Laboratory for Endocrinology and Metabolism, 1st Faculty of Medicine, Charles University and General Faculty Hospital, U Nemocnice 1, 12808, Prague 2, Czech Republic. jan.skrha@lf1.cuni.cz.

Reviews in Endocrine & Metabolic Disorders
|March 16, 2016
PubMed
Summary

Poor diabetes control, measured by HbA1c, links to microvascular issues. Glucose variability

Keywords:
Glucose variabilityHbA1c variabilityMicrovascular complicationsType 1 and Type 2 diabetes

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Area of Science:

  • Endocrinology and Metabolism
  • Diabetology
  • Vascular Biology

Background:

  • Microvascular complications in diabetes mellitus are linked to suboptimal long-term glycemic control, indicated by HbA1c levels.
  • Increased glucose variability is implicated in oxidative stress, endothelial dysfunction, and inflammation, key pathways in vascular damage.
  • The association between glucose variability and macrovascular disease is debated, and its role in microvascular disease remains controversial.

Purpose of the Study:

  • To review current research on glucose variability and its potential impact on diabetic retinopathy, nephropathy, and neuropathy.
  • To assess whether glucose variability is an independent risk factor for microvascular complications in diabetes.

Main Methods:

  • Literature review of recent studies on glucose variability and microvascular complications.
  • Analysis of the relationship between glucose fluctuations and specific microvascular outcomes (retinopathy, nephropathy, neuropathy).

Main Results:

  • Evidence suggests glucose fluctuations contribute to pathways involved in vascular damage.
  • The link between glucose variability and microvascular complications like retinopathy, nephropathy, and neuropathy requires further investigation.
  • Current data is insufficient to definitively establish glucose variability as an independent risk factor.

Conclusions:

  • Randomized prospective trials are needed to clarify the role of short-term glucose variability in microvascular complication development.
  • Further research should focus on establishing glucose variability as an independent risk factor for diabetes-related microvascular disease.