Factors associated with glycemic variability in Japanese patients with diabetes

Abstract

The aim of this study was to clarify determinants of glycemic variability in Japanese patients with diabetes. We performed continuous glucose monitoring (CGM) for 2–4 days in 88 patients with diabetes admitted to our hospital for poor glycemic control (20 with type 1 and 68 with type 2 diabetes). Glycemic variability was assessed by standard deviation (SD) of glucose and mean amplitude of glycemic excursions (MAGE) calculated from CGM data, and its relations to clinical parameters were investigated. Beta-cell function was assessed by serum C-peptide immunoreactivity (CPR) to glucose ratio (CPR index). As a result, glycemic variability was significantly greater in patients with type 1 diabetes than in those with type 2 diabetes. In all patients, the glycated albumin to HbA1c ratio (GA/HbA1c) was positively correlated and the postprandial CPR index was negatively correlated with SD and MAGE (both p < 0.05). In patients with type 2 diabetes, age, diabetes duration, and GA/HbA1c were significantly positively correlated with SD and MAGE, while multivariate analysis suggested that age and diabetes duration are the major determinants of glycemic variability. In conclusion, while glycemic variability was greater in patients with type 1 diabetes than those with type 2 diabetes, age, diabetes duration, GA/HbA1c, and beta-cell function were associated with glycemic variability in Japanese patients with diabetes.