Abstract
OBJECTIVEThis study analyzed data from the Epidemiology of Diabetes Interventions and Complications (EDIC) study to see whether longer-term follow-up of Diabetes Control and Complications Trial (DCCT) patients reveals a role for glycemic instability in the development of microvascular complications.RESEARCH DESIGN AND METHODSThe mean area under the curve glucose and the within-day glucose variability (SD and mean amplitude of glycemic excursions [MAGE]) during the DCCT were assessed to see whether they contributed to the risk of retinopathy and nephropathy by year 4 of the EDIC.RESULTSLogistic regression analysis showed that mean glucose during the DCCT and mean A1C during EDIC were independently predictive of retinopathy (each P < 0.001) as well as A1C during EDIC of nephropathy (P = 0.001) development by EDIC year 4. Glucose variability did not add to this (all P > 0.25 using SD or MAGE).CONCLUSIONSGlucose variability in the DCCT did not predict the development of retinopathy or nephropathy by EDIC year 4.
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