How Important is Blood Glucose Variability In The Management Of Type 2 Diabetes?

A group of researchers conducted a study to investigate the role of blood glucose (BG) variability in glycemic control in patients with type 2 diabetes.

A total of 117 participants, 48 with normal glucose regulation and 69 with newly diagnosed type 2 diabetes, were monitored using the continuous glucose monitoring system; a subset of 23 patients with type 2 diabetes characterized by poor glycemic control (reflected by HbA1c levels > 8.5%) were monitored a second time following 2 to 3 weeks of daily insulin injections. BG variability was calculated using the mean amplitude of daily excursions (MAGE), mean of daily differences (MODD), and the incremental areas above preprandial glucose values (AUCpp), and expressed as intra-day, inter-day, and postprandial BG variability.

The researchers found that MAGE, MODD, and AUCpp levels were significantly higher in patients with type 2 diabetes compared with participants with normal glucose regulation (p < 0.001), resulting in greater blood glucose variability in those patients. However, significant decreases were observed in the subset of patients that underwent intensive insulin therapy (MAGE, 41%; MODD, 29%; AUCpp, 49%; p < 0.001).

Postprandial hyperglycemia was most prominent following breakfast; peak intra-day values occurred at an average of 103 minutes after breakfast in 65.2% of the participants.

The researchers concluded that minimizing BG variability in patients with type 2 diabetes could be an important aspect of glucose management.
Med Sci Monit. 2008;14:CR552-8.