Effect of glucose variability on the long-term risk of microvascular complications in type 1 diabetes.
OBJECTIVE
This study analyzed data from the Epidemiology of Diabetes Interventions and Complications (EDIC) study to see whether longer-term follow-up of Diabetes Control and Complications Trial (DCCT) patients reveals a role for glycemic instability in the development of microvascular complications.


METHODS
The mean area under the curve glucose and the within-day glucose variability (SD and mean amplitude of glycemic excursions [MAGE]) during the DCCT were assessed to see whether they contributed to the risk of retinopathy and nephropathy by year 4 of the EDIC.


RESULTS
Logistic regression analysis showed that mean glucose during the DCCT and mean A1C during EDIC were independently predictive of retinopathy (each P < 0.001) as well as A1C during EDIC of nephropathy (P = 0.001) development by EDIC year 4. Glucose variability did not add to this (all P > 0.25 using SD or MAGE).


CONCLUSIONS
Glucose variability in the DCCT did not predict the development of retinopathy or nephropathy by EDIC year 4.
Kilpatrick
Eric S
ES
Department of Clinical Biochemistry, Hull Royal Infirmary, Hull, UK. eric.kilpatrick@hey.nhs.uk
Rigby
Alan S
AS
Atkin
Stephen L
SL
D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000209:etiology / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000209:etiology / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D055806:Microvessels / Q000503:physiopathology; D012307:Risk Factors; D014652:Vascular Diseases / Q000503:physiopathology
D001786:Blood Glucose; D006442:Glycated Hemoglobin