title: The challenges of measuring glycemic variability.
abstract: This commentary reviews several of the challenges encountered when attempting to quantify glycemic variability and correlate it with risk of diabetes complications. These challenges include (1) immaturity of the field, including problems of data accuracy, precision, reliability, cost, and availability; (2) larger relative error in the estimates of glycemic variability than in the estimates of the mean glucose; (3) high correlation between glycemic variability and mean glucose level; (4) multiplicity of measures; (5) correlation of the multiple measures; (6) duplication or reinvention of methods; (7) confusion of measures of glycemic variability with measures of quality of glycemic control; (8) the problem of multiple comparisons when assessing relationships among multiple measures of variability and multiple clinical end points; and (9) differing needs for routine clinical practice and clinical research applications.
authors: Biomedical Informatics Consultants LLC, Potomac, Maryland 20854-4721, USA. drodbard@comcast.net
authors: David
authors: D
authors: Rodbard
mesh_terms: D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D003627:Data Interpretation, Statistical; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis; D018450:Disease Progression; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors; D035501:Uncertainty
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human