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Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes

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Umpierrez, Guillermo E., P. Kovatchev, Boris·2018·The American Journal of the Medical Sciences

DOI 10.1016/j.amjms.2018.09.010PMC PMC6709582

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Abstract

(A1C) levels have traditionally been the gold standard for assessing glycemic control and treatment efficacy in patients with type 2 diabetes. However, A1C does not take into account fluctuations in blood glucose levels known as glycemic variability (GV). In recent years, GV has become increasingly clinically relevant, because of a better understanding of the need to reach target A1C while avoiding hypoglycemia. GV relates to both hyperglycemia and hypoglycemia, and has been associated with poorer quality of life. Diabetes treatments targeting multiple pathophysiological mechanisms are most beneficial in controlling A1C and reducing GV. In clinical trials, a number of metrics are used to measure GV, many of which are not well understood in the clinical practice. Until a gold standard metric for GV is established, the variety of measurements available may confound the choice of an optimal treatment for an individual patient.

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Authors: Umpierrez, G. E., & P. Kovatchev, B.
Affiliations: Emory University (US)
Corresponding author: Umpierrez, Guillermo E.
ORCID: Umpierrez, Guillermo E.
Venue: The American Journal of the Medical Sciences
Publisher: Elsevier BV
Published: 2018-12
Volume: 356
Issue: 6
Pages: 518-527
ISSN: 0002-9629 (ISSN-L)
DOI: 10.1016/j.amjms.2018.09.010
PMC: PMC6709582
OpenAlex: W2895746197
Cited by: 148
References: 67
Citations by year: 2026: 10 · 2025: 12 · 2024: 23 · 2023: 25 · 2022: 31 · 2021: 27 · 2020: 13 · 2019: 7
FWCI: 1.88
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
Locations: The American Journal of the Medical Sciences (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health
University of Virginia
National Institute of Diabetes and Digestive and Kidney Diseases
Merck
National Center for Research Resources
Sanofi
Boehringer Ingelheim
Novo Nordisk
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: glycemic variability, type 2 diabetes, HbA1c, glycemic control, hypoglycemia, hyperglycemia, quality of life
MeSH terms: Blood Glucose, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Hyperglycemia, Hypoglycemia, Treatment Outcome

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Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes

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