Advances in Understanding Glucose Variability and the Role of Continuous Glucose Monitoring

Abstract

Recent data have suggested that glucose variability may add to or modify the risk of diabetes complications. Glycated haemoglobin (HbA1c), an integrated measure of sustained chronic hyperglycaemia, fails to reflect glucose variability and the risks associated with extreme glucose swings. Thus, whether glucose variability should become an integral part of assessing glucose control in clinical practice remains unknown. Since the establishment of continuous glucose monitoring (CGM) systems, various indices of glucose variability and quality of glycaemic control such as the mean amplitude of glycaemic excursions (MAGE) and the Glycaemic Risk Assessment Diabetes Equation (GRADE) can now be precisely computed from CGM data sets. Analysis of CGM data, including the impact of glucose variability and its temporal aspects, has clinical importance and should be incorporated into use in clinical trials and the design of optimal antidiabetes therapies.