Is glycemic variability important to assessing antidiabetes therapies?

Traditionally, statistical estimation of glycemic variability includes computing standard deviation of glucose readings or related statistics (eg, M value, mean amplitude of glucose excursions, and so forth). We advocate an alternative approach using risk measures of variability, which have substantial clinical and numerical advantages. In addition, continuous glucose monitoring (CGM) data have clinically important inherent temporal structure that should be taken into consideration. Thus, temporal variability methods are discussed for the analysis and interpretation of CGM output.

[1]  Michael Brownlee,et al.  Glycemic variability: a hemoglobin A1c-independent risk factor for diabetic complications. , 2006, JAMA.

[2]  D. Cox,et al.  Symmetrization of the Blood Glucose Measurement Scale and Its Applications , 1997, Diabetes Care.

[3]  I. Deary,et al.  Hypoglycaemia in insulin‐treated Type 2 diabetes: frequency, symptoms and impaired awareness , 2003, Diabetic medicine : a journal of the British Diabetic Association.

[4]  M. Hanefeld,et al.  Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose or HbA1c level. , 2000, Diabetes care.

[5]  A. Luciani,et al.  Evidence for early impairment of glucagon-like peptide 1-induced insulin secretion in human type 2 (non insulin-dependent) diabetes. , 2002, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[6]  K. Freedland,et al.  The prevalence of comorbid depression in adults with diabetes: a meta-analysis. , 2001, Diabetes care.

[7]  Jean-Paul Cristol,et al.  Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. , 2006, JAMA.

[8]  B P Kovatchev,et al.  Episodes of severe hypoglycemia in type 1 diabetes are preceded and followed within 48 hours by measurable disturbances in blood glucose. , 2000, The Journal of clinical endocrinology and metabolism.

[9]  J. Nerup,et al.  Glycosylated haemoglobin and steady-state mean blood glucose concentration in type 1 (insulin-dependent) diabetes , 1982, Diabetologia.

[10]  R. Holman,et al.  Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. , 1998 .

[11]  J. Santiago.  Lessons From the Diabetes Control and Complications Trial , 1993, Diabetes.

[12]  M. Igarashi,et al.  [Syndromes of insulin resistance]. , 1991, Nihon rinsho. Japanese journal of clinical medicine.

[13]  P. Cryer.  Hypoglycemia: Pathophysiology, Diagnosis, and Treatment , 1997 .

[14]  R. Kalyani,et al.  Assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin A1c. , 2006, JAMA.

[15]  S. Haffner.  The importance of postprandial hyperglycaemia in development of cardiovascular disease in people with diabetes: point. , 2001, International journal of clinical practice. Supplement.

[16]  William L Clarke,et al.  Quantifying temporal glucose variability in diabetes via continuous glucose monitoring: mathematical methods and clinical application. , 2005, Diabetes technology & therapeutics.

[17]  J. Gerich,et al.  Lack of Glucagon Response to Hypoglycemia in Diabetes: Evidence for an Intrinsic Pancreatic Alpha Cell Defect , 1973, Science.

[18]  H. Elrick,et al.  PLASMA INSULIN RESPONSE TO ORAL AND INTRAVENOUS GLUCOSE ADMINISTRATION. , 1964, The Journal of clinical endocrinology and metabolism.

[19]  Workgroup on Hypoglycemia.  Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia. , 2005, Diabetes care.

[20]  P. Cryer,et al.  Hypoglycaemia: The limiting factor in the glycaemic management of Type I and Type II Diabetes* , 2002, Diabetologia.

[21]  J. Holst,et al.  Impaired incretin response after a mixed meal is associated with insulin resistance in nondiabetic men. , 2001, Diabetes care.

[22]  R. Clouse,et al.  Treatment of depression in diabetes: impact on mood and medical outcome. , 2002, Journal of psychosomatic research.

[23]  Martin Straume,et al.  Risk Analysis of Blood Glucose Data: A Quantitative Approach to Optimizing the Control of Insulin Dependent Diabetes , 2000 .

[24]  P. Cryer,et al.  Brief twice-weekly episodes of hypoglycemia reduce detection of clinical hypoglycemia in type 1 diabetes mellitus. , 1998, Diabetes.

[25]  R. Clouse,et al.  Depression in diabetic patients: the relationship between mood and glycemic control. , 2005, Journal of diabetes and its complications.

[26]  F J Snoek,et al.  Symptoms and Well-Being in Relation to Glycemic Control in Type II Diabetes , 1996, Diabetes Care.

[27]  D. Klonoff.  Continuous glucose monitoring: roadmap for 21st century diabetes therapy. , 2005, Diabetes care.

[28]  J. Beck,et al.  Stimulation of Release of Insulin by an Extract of Intestinal Mucosa , 1966, Diabetes.

[29]  W. F. Taylor,et al.  Mean Amplitude of Glycemic Excursions, a Measure of Diabetic Instability , 1970, Diabetes.

[30]  W. Tamborlane,et al.  Effect of Intensive Insulin Therapy on Glycemic Thresholds for Counterregulatory Hormone Release , 1988, Diabetes.

[31]  J. Schlichtkrull,et al.  [M-VALUE, AN INDEX FOR BLOOD SUGAR CONTROL IN DIABETICS]. , 1964, Ugeskrift for laeger.

[32]  I. Deary,et al.  Recurrent Severe Hypoglycaemia and Cognitive Function in Type 1 Diabetes , 1993, Diabetic medicine : a journal of the British Diabetic Association.

[33]  A. McElduff,et al.  Diabetes Control and Complications Trial , 1993 .

[34]  P. Cryer,et al.  Hypoglycemia-associated autonomic failure in advanced type 2 diabetes. , 2002, Diabetes.

[35]  Daniel J Cox,et al.  Algorithmic evaluation of metabolic control and risk of severe hypoglycemia in type 1 and type 2 diabetes using self-monitoring blood glucose data. , 2003, Diabetes technology & therapeutics.

[36]  A. Shapiro,et al.  Assessment of the severity of hypoglycemia and glycemic lability in type 1 diabetic subjects undergoing islet transplantation. , 2004, Diabetes.

[37]  G. Ghirlanda,et al.  What is the real contribution of fasting plasma glucose and postprandial glucose in predicting HbA(1c) and overall blood glucose control? , 2001, Diabetes care.

[38]  C. Cobelli,et al.  Effects of a change in the pattern of insulin delivery on carbohydrate tolerance in diabetic and nondiabetic humans in the presence of differing degrees of insulin resistance. , 1996, The Journal of clinical investigation.

[39]  P. Cryer.  Iatrogenic Hypoglycemia as a Cause of Hypoglycemia-Associated Autonomic Failure in IDDM: A Vicious Cycle , 1992, Diabetes.

[40]  Daniel J Cox,et al.  Relationships between hyperglycemia and cognitive performance among adults with type 1 and type 2 diabetes. , 2005, Diabetes care.

[41]  R. Marfella,et al.  Regression of Carotid Atherosclerosis by Control of Postprandial Hyperglycemia in Type 2 Diabetes Mellitus , 2004, Circulation.

[42]  G. Reaven,et al.  Pathophysiology of insulin resistance in human disease. , 1995, Physiological reviews.

[43]  B P Kovatchev,et al.  Assessment of risk for severe hypoglycemia among adults with IDDM: validation of the low blood glucose index. , 1998, Diabetes care.

[44]  D. Drucker.  Enhancing incretin action for the treatment of type 2 diabetes. , 2003, Diabetes care.