title: Assessment of the association between glycemic variability and diabetes-related complications in type 1 and type 2 diabetes.
abstract: Chronic hyperglycemia is the main risk factor for the development of diabetes-related complications in both type 1 and type 2 diabetes, but it is thought that frequent or large glucose fluctuations may contribute independently to diabetes-related complications. A systematic literature review was performed using the PubMed, EMBASE and Cochrane Library databases with searches limited to studies published from June 2002 to March 2014, in English and including ≥50 patients. Twenty eight articles were included in the final review. Eighteen studies reported the association between glucose variability and diabetes-related complications exclusively in type 2 diabetes. A positive association between increased variability and microvascular complications and coronary artery disease was consistently reported. Associations between glucose variability and other macrovascular complications were inconsistent in type 2 diabetes. Seven studies examined the association between glucose variability and complications exclusively in type 1 diabetes. Increased glucose variability appears to play a minimal role in the development of micro- and macrovascular complications in type 1 diabetes. Consistent findings suggest that in type 2 diabetes glucose variability is associated with development of microvascular complications. The role of increased glucose variability in terms of microvascular and macrovascular complications in type 1 diabetes is less clear; more data in are needed.
authors.affiliation: Ossian Health Economics and Communications, Basel, Switzerland. Electronic address: smith-palmer@ossianconsulting.com.
authors.forename: J
authors.initials: J
authors.lastname: Smith-Palmer
authors.affiliation: Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Brändle
authors.affiliation: Ospedali Riuniti di Bergamo, Bergamo, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Trevisan
authors.affiliation: Medtronic Italia, S.p.A, Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Orsini Federici
authors.affiliation: Medtronic International Trading Sàrl, Tolochenaz, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Liabat
authors.affiliation: Ossian Health Economics and Communications, Basel, Switzerland.
authors.forename: W
authors.initials: W
authors.lastname: Valentine
mesh_terms: D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D003324:Coronary Artery Disease / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003928:Diabetic Nephropathies / Q000209:etiology; D003930:Diabetic Retinopathy / Q000209:etiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008297:Male; D018384:Oxidative Stress; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Glycemic variability; Macrovascular complications; Microvascular complications