Glycemic variability in the development of cardiovascular complications in diabetes

Diabetes Metab Res Rev. 2018 Nov;34(8):e3047. doi: 10.1002/dmrr.3047. Epub 2018 Aug 9.

Abstract

Diabetes mellitus represents a major risk factor for the development of coronary artery disease and other vascular complications. Glycated haemoglobin, fructosamine, and fasting blood glucose levels are partial parameters to exhaustively describe patient dysglycemic status. Thus, recently the new concept of glycemic variability has emerged, including information about two major aspects: the magnitude of blood glucose excursions (from nadir to peak, thus lower and higher spikes) and the time intervals in which these fluctuations occur. Despite the lack of consensus regarding the most appropriate definition and tools for its assessment, glycemic variability seems to have more deleterious effects than sustained hyperglycemia in the pathogenesis of diabetic cardiovascular complications. This manuscript aimed to review the most recent evidence on glycemic variability and its potential use in everyday clinical practice to identify diabetic patients at higher risk of cardiovascular complications and thus needing stricter monitoring and treatment.

Keywords: cardiovascular complications; coronary artery disease; diabetes mellitus; glycemic variability.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / etiology
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Angiopathies / blood
  • Diabetic Angiopathies / etiology*
  • Glycated Hemoglobin / metabolism
  • Humans

Substances

  • Blood Glucose
  • Glycated Hemoglobin A