Toward Defining the Threshold Between Low and High Glucose Variability in Diabetes
Louis Monnier1, Claude Colette2, Anne Wojtusciszyn3
1Institute of Clinical Research, University of Montpellier, Montpellier, France louis.monnier@inserm.fr.
Diabetes Care
|January 1, 2017
Summary
A glucose variability (GV) threshold of 36% distinguishes stable from unstable glycemia in diabetes. Exceeding this threshold significantly increases hypoglycemia risk, particularly for insulin-treated patients.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Diabetes Management
Background:
- Glucose variability (GV) is a key indicator of dysglycemia in diabetes.
- Defining a threshold for excess GV is crucial for clinical management.
Purpose of the Study:
- To establish a definitive threshold for excess glucose variability (GV) in diabetic patients.
- To correlate GV levels with the frequency of hypoglycemia across different diabetes treatment groups.
Main Methods:
- Continuous glucose monitoring was performed on 376 individuals with diabetes (Type 1 and Type 2).
- Participants were categorized into four groups based on their diabetes treatment regimen.
- Percentage coefficient of variation for glucose (%CV) and hypoglycemia frequencies were calculated.
Main Results:
- Median %CV increased significantly across treatment groups, ranging from 18.1% in diet/sensitizer-treated patients to 37.2% in Type 1 diabetes.
- A %CV of 36% was identified as the upper limit for stable glycemia in the reference group.
- Patients with %CV >36% exhibited significantly higher rates of hypoglycemia, especially those on insulin therapy.
Conclusions:
- A %CV threshold of 36% effectively differentiates between stable and unstable glycemic control in diabetes.
- This threshold is particularly relevant for identifying increased hypoglycemia risk in insulin-treated individuals.
- The findings support the use of GV metrics in optimizing diabetes care and preventing hypoglycemic events.
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