title: Normal reference range for mean tissue glucose and glycemic variability derived from continuous glucose monitoring for subjects without diabetes in different ethnic groups.
abstract: BACKGROUND
  Glycemic variability has been proposed as a contributing factor in the development of diabetes complications. Multiple measures exist to calculate the magnitude of glycemic variability, but normative ranges for subjects without diabetes have not been described. For treatment targets and clinical research we present normative ranges for published measures of glycemic variability.
  
  
  METHODS
  Seventy-eight subjects without diabetes having a fasting plasma glucose of <120 mg/dL (6.7 mmol/L) underwent up to 72 h of continuous glucose monitoring (CGM) with a Medtronic Minimed (Northridge, CA) CGMS(®) Gold device. Glycemic variability was calculated using EasyGV(©) software (available free for non-commercial use at www.easygv.co.uk ), a custom program that calculates the SD, M-value, mean amplitude of glycemic excursions (MAGE), average daily risk ratio (ADRR), Lability Index (LI), J-Index, Low Blood Glucose Index (LBGI), High Blood Glucose Index (HBGI), continuous overlapping net glycemic action (CONGA), mean of daily differences (MODD), Glycemic Risk Assessment in Diabetes Equation (GRADE), and mean absolute glucose (MAG).
  
  
  RESULTS
  Eight CGM traces were excluded because there were inadequate data. From the remaining 70 traces, normative reference ranges (mean±2 SD) for glycemic variability were calculated: SD, 0-3.0; CONGA, 3.6-5.5; LI, 0.0-4.7; J-Index, 4.7-23.6; LBGI, 0.0-6.9; HBGI, 0.0-7.7; GRADE, 0.0-4.7; MODD, 0.0-3.5; MAGE-CGM, 0.0-2.8; ADDR, 0.0-8.7; M-value, 0.0-12.5; and MAG, 0.5-2.2.
  
  
  CONCLUSIONS
  We present normative ranges for measures of glycemic variability in adult subjects without diabetes for use in clinical care and academic research.
authors.affiliation: Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom. nathan.hill@ocdem.ox.ac.uk
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Hill
authors.forename: Nick S
authors.initials: NS
authors.lastname: Oliver
authors.forename: Pratik
authors.initials: P
authors.lastname: Choudhary
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Levy
authors.forename: Peter
authors.initials: P
authors.lastname: Hindmarsh
authors.forename: David R
authors.initials: DR
authors.lastname: Matthews
mesh_terms: D000328:Adult; D001741:Black or African American; D044466:Asian People; D044383:Black People; D001786:Blood Glucose / Q000032:analysis*; D002940:Circadian Rhythm; D045604:Extracellular Fluid / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory; D012016:Reference Values; D040521:Subcutaneous Tissue / Q000378:metabolism*; D014481:United States; D044465:White People; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D005947:Glucose