Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes
Glycated hemoglobin A1c (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...
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| Veröffentlicht in: | The American journal of the medical sciences 2018-12, Vol.356 (6), p.518-527 |
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| creator | Umpierrez, Guillermo E. P. Kovatchev, Boris |
| description | Glycated hemoglobin A1c (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. |
| doi_str_mv | 10.1016/j.amjms.2018.09.010 |
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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.</description><identifier>ISSN: 0002-9629</identifier><identifier>ISSN: 1538-2990</identifier><identifier>EISSN: 1538-2990</identifier><identifier>DOI: 10.1016/j.amjms.2018.09.010</identifier><identifier>PMID: 30447705</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blood Glucose - analysis ; Diabetes Mellitus, Type 2 - drug therapy ; Glycated Hemoglobin - metabolism ; Glycated hemoglobin A1c ; Glycemic control ; Glycemic variability ; Humans ; Hyperglycemia - drug therapy ; Hypoglycemia - drug therapy ; Treatment Outcome ; Type 2 diabetes</subject><ispartof>The American journal of the medical sciences, 2018-12, Vol.356 (6), p.518-527</ispartof><rights>2018</rights><rights>Copyright © 2018 by the Southern Society for Clinical Investigation. Unauthorized reproduction of this article is prohibited.</rights><rights>Copyright © 2018. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5703-97ac8b26c2ec7d58925adedcc0f702bf89c0ad88bf103ff7b07f482260f52bef3</citedby><cites>FETCH-LOGICAL-c5703-97ac8b26c2ec7d58925adedcc0f702bf89c0ad88bf103ff7b07f482260f52bef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30447705$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Umpierrez, Guillermo E.</creatorcontrib><creatorcontrib>P. Kovatchev, Boris</creatorcontrib><title>Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes</title><title>The American journal of the medical sciences</title><addtitle>Am J Med Sci</addtitle><description>Glycated hemoglobin A1c (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.</description><subject>Blood Glucose - analysis</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Glycated Hemoglobin - metabolism</subject><subject>Glycated hemoglobin A1c</subject><subject>Glycemic control</subject><subject>Glycemic variability</subject><subject>Humans</subject><subject>Hyperglycemia - drug therapy</subject><subject>Hypoglycemia - drug therapy</subject><subject>Treatment Outcome</subject><subject>Type 2 diabetes</subject><issn>0002-9629</issn><issn>1538-2990</issn><issn>1538-2990</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS0EotvCJ0BCPnJJGDt_jQQSWmi7UhGXlqvlOGPWixMvdtLVfnsctlRwwZexx-_3PPIj5BWDnAGr3-5yNeyGmHNgbQ4iBwZPyIpVRZtxIeApWQEAz0TNxRk5j3EHwHjLiufkrICybBqoVuTuyh01DlbTbypY1Vlnp-M7eu0PdPL0C6o4B6Rq7OlminTt7Gi1cnQz7F3aTNaP1PhAb497pJx-Sg44YXxBnhnlIr58qBfk7vLz7fo6u_l6tVl_vMl01UCRiUbptuO15qibvmoFr1SPvdZgGuCdaYUG1bdtZxgUxjQdNKZsOa_BVLxDU1yQDyff_dwNCcRxCsrJfbCDCkfplZX_3ox2K7_7e1k3IKqWJ4M3DwbB_5wxTnKwUaNzakQ_R8lZUdVFJbhI0uIk1cHHGNA8PsNALoHInfwdiFwCkSBkCiRRr_-e8JH5k0ASlCfBwbsJQ_zh5gMGuUXlpq2EZZUlyxZPxtMhWzpFwt6fMEzfe28TEbXFUWNvA-pJ9t7-d65fL8SuDA</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Umpierrez, Guillermo E.</creator><creator>P. Kovatchev, Boris</creator><general>Elsevier Inc</general><general>Copyright by the Southern Society for Clinical Investigation. Unauthorized reproduction of this article is prohibited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201812</creationdate><title>Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes</title><author>Umpierrez, Guillermo E. ; P. Kovatchev, Boris</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5703-97ac8b26c2ec7d58925adedcc0f702bf89c0ad88bf103ff7b07f482260f52bef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Blood Glucose - analysis</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Glycated Hemoglobin - metabolism</topic><topic>Glycated hemoglobin A1c</topic><topic>Glycemic control</topic><topic>Glycemic variability</topic><topic>Humans</topic><topic>Hyperglycemia - drug therapy</topic><topic>Hypoglycemia - drug therapy</topic><topic>Treatment Outcome</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Umpierrez, Guillermo E.</creatorcontrib><creatorcontrib>P. Kovatchev, Boris</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of the medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Umpierrez, Guillermo E.</au><au>P. Kovatchev, Boris</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes</atitle><jtitle>The American journal of the medical sciences</jtitle><addtitle>Am J Med Sci</addtitle><date>2018-12</date><risdate>2018</risdate><volume>356</volume><issue>6</issue><spage>518</spage><epage>527</epage><pages>518-527</pages><issn>0002-9629</issn><issn>1538-2990</issn><eissn>1538-2990</eissn><abstract>Glycated hemoglobin A1c (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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30447705</pmid><doi>10.1016/j.amjms.2018.09.010</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Blood Glucose - analysis Diabetes Mellitus, Type 2 - drug therapy Glycated Hemoglobin - metabolism Glycated hemoglobin A1c Glycemic control Glycemic variability Humans Hyperglycemia - drug therapy Hypoglycemia - drug therapy Treatment Outcome Type 2 diabetes |
| title | Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes |
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