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Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes
Open accessAbstract
(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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“Recent clinical data indicate that GV is associated with increased risk of hypoglycemia, microvascular and macrovascular complications, and mortality in patients with diabetes, independently of glycated hemoglobin level.”
From Glycemic variability and cardiovascular disease in patients with type 2 diabetes (2021) · cites this paper as [13]
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Metadata
- Authors
- Umpierrez, G. E., & P. Kovatchev, B.
- Affiliations
- Emory University (US)
- Corresponding author
- 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)
- 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
- 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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