Glycemic variability and cardiovascular disease in patients with type 2 diabetes

Marcela Martinez, Jimena Santamarina, Adrian Pavesi, Carla Musso, Guillermo E Umpierrez, Marcela Martinez, Jimena Santamarina, Adrian Pavesi, Carla Musso, Guillermo E Umpierrez

Abstract

Glycated hemoglobin is currently the gold standard for assessment of long-term glycemic control and response to medical treatment in patients with diabetes. Glycated hemoglobin, however, does not address fluctuations in blood glucose. Glycemic variability (GV) refers to fluctuations in blood glucose levels. 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. The use of continuous glucose monitoring devices has markedly improved the assessment of GV in clinical practice and facilitated the assessment of GV as well as hypoglycemia and hyperglycemia events in patients with diabetes. We review current concepts on the definition and assessment of GV and its association with cardiovascular complications in patients with type 2 diabetes.

Keywords: cardiovascular system; diabetes mellitus; diagnostic techniques and procedures; type 2.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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