Journal: Diabetes, Obesity and Metabolism
Credit: 1.0 AMA PRA Category 1 CreditTM
Release Date: December 16, 2024
Abstract
With the widespread use of continuous glucose monitoring (CGM), glycaemic variability (GV) is a glucose metric that has been gaining increasing attention. However, unlike other glucose metrics that are easily defined and have clear targets, GV has a large number of different measures given the complexity involved in assessment. While variabilities in HbA1c, fasting and postprandial glucose have been incorporated under the GV banner, short-term variability in glucose, within day and between days, is more in keeping with the correct definition of GV. This review is focused on short-term GV, as assessed by CGM data, although studies calculating GV from capillary glucose testing are also mentioned as appropriate. The different measures of GV are addressed, and their potential role in microvascular and macrovascular complications, as well as patient-related outcomes, discussed. It should be noted that the independent role of GV in vascular pathology is not always clear, given the inconsistent findings in different populations and the close association between GV and hypoglycaemia, itself an established risk factor for adverse outcomes. Therefore, this review attempts, where possible, to disentangle the contribution of GV to diabetes complications from other glycaemic parameters, particularly hypoglycaemia. Evidence to date strongly suggests an independent role for GV in vascular pathology but future large-scale outcome studies are required to fully understand the exact contribution of this metric to vascular complications. This can be followed by setting appropriate GV measures and targets in different diabetes subgroups, in order to optimise glycaemic management and limit the risk of complications.
Activity Disclosures
This publication is made possible by an educational grant from Abbott Diabetes Care, but the authors, individually and collectively, were responsible for its content. (Supporter identity was not disclosed to the authors or the journal peer reviewers prior to publication).
No conflicts of interest or financial relationships relevant to this activity were reported.
This activity underwent peer review in line with standards of editorial integrity and publication ethics. Conflicts of interest have been identified and resolved in accordance with John Wiley and Sons, Inc.’s Policy on Activity Disclosure and Conflict of Interest.
Accreditation
John Wiley and Sons, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. John Wiley and Sons, Inc. designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
For information on applicability and acceptance of continuing medical education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within 1 hour. To successfully earn credit, participants must complete the activity during the valid credit period, which is up to three years from initial publication. Additionally, a score of 70% or better is needed to pass the post test.
