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Glycaemic variability in diabetes: clinical and therapeutic implications
Abstract
Glycaemic variability is an integral component of glucose homoeostasis. Although it has not yet been definitively confirmed as an independent risk factor for diabetes complications, glycaemic variability can represent the presence of excess glycaemic excursions and, consequently, the risk of hyperglycaemia or hypoglycaemia. Glycaemic variability is currently defined by a large and increasing number of metrics, representing either short-term (within-day and between-day variability) or long-term glycaemic variability, which is usually based on serial measurements of HbA 1c or other measures of glycaemia over a longer period of time. In this Review, we discuss recent evidence examining the association between glycaemic variability and diabetes-related complications, as well as non-pharmacological and pharmacological strategies currently available to address this challenging aspect of diabetes management.
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“It also complicates both the achievement of recommended glycated hemoglobin (HbA1c) and time in range (TIR) targets [101, 102].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [101]
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“increased risk of cardiovascular disease18–20”
From Glycemic variability and cardiovascular disease in patients with type 2 diabetes (2021) · cites this paper as [19]
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Metadata
- Authors
- Ceriello, A., Monnier, L., & Owens, D.
- Affiliations
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (ES)
- Université de Montpellier (FR)
- Swansea University (GB)
- Corresponding author
- Ceriello, Antonio
- Venue
- The Lancet Diabetes & Endocrinology
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 7
- Issue
- 3
- Pages
- 221-230
- ISSN
- 2213-8587 (ISSN-L)
- OpenAlex
- W2886853964
- Cited by
- 588
- References
- 107
- Citations by year
- 2026: 58 · 2025: 71 · 2024: 78 · 2023: 81 · 2022: 81 · 2021: 96 · 2020: 87 · 2019: 36
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Diabetes & Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- 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 › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Keywords
- glycemic variability, diabetes mellitus, glucose homeostasis, glycaemic excursions, hyperglycemia, hypoglycemia, diabetes complications, HbA1c, diabetes management, glycemic control
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Glycated Hemoglobin, Humans, Hyperglycemia, Hypoglycemia, Hypoglycemic Agents, Blood Glucose Self-Monitoring, Monitoring, Ambulatory, Diabetes Complications
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