Glycemic Variability: How Do We Measure It and Why Is It Important?
Glycemic Variability: How Do We Measure It and Why Is It Important?
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DOI：
10.4093/dmj.2015.39.4.273
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发表时间：
2015-08
影响因子：
5.9
通讯作者：
Kim JH
中科院分区：
文献类型：
--
作者：
Suh S;Kim JH
慢性高血糖症是糖尿病（DM）并发症发生的主要风险因素;然而，据信频繁或大幅血糖波动可能独立导致糖尿病相关并发症。餐后血糖峰值以及低血糖事件被认为是糖尿病心血管事件增加的原因。Glycoside变异性（GV）包括这两种事件;因此，最大限度地减少GV可以预防未来的心血管事件。纠正GV成为临床实践中追求的目标，以安全地降低平均血糖并确定其对糖尿病血管并发症的直接影响。现代糖尿病管理模式，包括基于胰高血糖素相关肽-1的治疗，更新的胰岛素，现代胰岛素泵和减肥手术，显着降低GV。然而，界定全球价值仍然是一个挑战，主要是因为难以衡量全球价值，而且在管理全球价值的最佳方法方面缺乏共识。本文的目的不仅是回顾GV的最新证据，而且还帮助读者更好地了解可用的测量选项以及各种定义如何与糖尿病并发症的发展有不同的关系。
Chronic hyperglycemia is the primary risk factor for the development of complications in diabetes mellitus (DM); however, it is believed that frequent or large glucose fluctuations may independently contribute to diabetes-related complications. Postprandial spikes in blood glucose, as well as hypoglycemic events, are blamed for increased cardiovascular events in DM. Glycemic variability (GV) includes both of these events; hence, minimizing GV can prevent future cardiovascular events. Correcting GV emerges as a target to be pursued in clinical practice to safely reduce the mean blood glucose and to determine its direct effects on vascular complications in diabetes. Modern diabetes management modalities, including glucagon-related peptide-1-based therapy, newer insulins, modern insulin pumps and bariatric surgery, significantly reduce GV. However, defining GV remains a challenge primarily due to the difficulty of measuring it and the lack of consensus regarding the optimal approach for its management. The purpose of this manuscript was not only to review the most recent evidence on GV but also to help readers better understand the available measurement options and how the various definitions relate differently to the development of diabetic complications.