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Glucose variability: a new parameter of diabetes compensation?


Authors: Martin Haluzík
Authors‘ workplace: III. interní klinika 1. LF UK a VFN, Praha, Česká republika
Published in: Forum Diab 2012; 1(2-3): 71-76
Category: Topic

Overview

Glycated hemoglobin and other parameters currently used to assess diabetes compensation do not necessarily reflect a complete real picture of diabetes control in all patients. Patients with profound oscillations of blood glucose from hypo- to hyperglycemic values with relatively satisfactory glycated hemoglobin and random fasting glucose represent a typical example of this fact. Most of experimental and some of clinical studies have suggested that major blood glucose oscillations may through the stimulation of oxidative stress and other mechanisms contribute to the development of diabetic complications and increased cardiovascular risk independently of diabetes compensation measured by glycated hemoglobin. A parameter that mathematically defines glucose oscillations within a defined time frame is commonly referred to as glucose variability. The aim of this review is to discuss cu­rrent knowledge with respect to relationship of glucose variability and long-term diabetic complications, prediction of hypoglycemia and other clinically relevant parameters. Several studies have suggested that glucose variability may become another important parameter reflecting the quality of diabetes compensation and the risk of long-term complications. It is possible that reduction of glucose variability could additionally decrease the risk of complications independently of diabetes compensation measured by glycated hemoglobin values. Further prospective interventional studies are necessary to confirm this interesting prospect.

Key words:
diabetes compensation – glucose variability – complications – hypoglycemia


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