title: Glycemic Variability: Assessing Glycemia Differently and the Implications for Dietary Management of Diabetes.
abstract: The primary therapeutic target for diabetes management is the achievement of good glycemic control, of which glycated hemoglobin (HbA1c) remains the standard clinical marker. However, glycemic variability (GV; the amplitude, frequency, and duration of glycemic fluctuations around mean blood glucose) is an emerging target for blood glucose control. A growing body of evidence supports GV as an independent risk factor for diabetes complications. Several techniques have been developed to assess and quantify intraday and interday GV. Additionally, GV can be influenced by several nutritional factors, including carbohydrate quality, quantity; and distribution; protein intake; and fiber intake. These factors have important implications for clinical nutrition practice and for optimizing blood glucose control for diabetes management. This review discusses the available evidence for GV as a marker of glycemic control and risk factor for diabetes complications. GV quantification techniques and the influence of nutritional considerations for diabetes management are also discussed.
authors.affiliation: Commonwealth Scientific and Industrial Research Organisation (CSIRO)-Food and Nutrition Flagship, Adelaide, South Australia 5000, Australia; email: jeannie.tay@csiro.au.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Tay
authors.forename: Campbell H
authors.initials: CH
authors.lastname: Thompson
authors.forename: Grant D
authors.initials: GD
authors.lastname: Brinkworth
mesh_terms: D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism*; D002318:Cardiovascular Diseases; D048909:Diabetes Complications / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood* / Q000178:diet therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D004032:Diet; D004040:Dietary Carbohydrates; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005215:Fasting; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D009747:Nutritional Physiological Phenomena; D018384:Oxidative Stress / Q000502:physiology; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D004044:Dietary Proteins; D006442:Glycated Hemoglobin
keywords: diabetes; diet; glycemic control; nutrition; postprandial