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Complications of diabetes and metrics of glycaemic management derived from continuous glucose monitoring1.64 MB
Published VersionCC BY V4.0, Open Access
Journal article
Complications of diabetes and metrics of glycaemic management derived from continuous glucose monitoring
Journal of Clinical Endocrinology and Metabolism, Vol.107(6), pp.2221-2236
2022
PMID: 35094087
Abstract
Context:
Although HbA1c is currently the best parameter used clinically to assess risk for the development of diabetes complications, it does not provide insight into short-term fluctuations in glucose levels. This review summarises the relationship between continuous glucose monitoring (CGM)-derived metrics of glycaemic variability and diabetes-related complications.
Evidence acquisition:
Pubmed and Embase databases were searched from 1 st January 2010 to 22 nd August 2020, using terms: type 1 diabetes, type 2 diabetes, diabetes-related micro- and macrovascular complications, measures of glycaemic variability. Exclusion criteria were studies that did not use CGM and studies involving participants who were: not diabetic, acutely unwell (post-stroke, post-surgery), pregnant or utilising insulin pumps.
Evidence synthesis:
1,636 records were identified, and 1,602 were excluded, leaving 34 publications in the final review. Of the 20,852 total participants, 663 had type 1 diabetes and 19,909 had type 2 diabetes. Glycaemic variability and low time-in-range (TIR) showed associations with all studied microvascular and macrovascular complications of diabetes. Notably, higher TIR associated with reduced risk of albuminuria, retinopathy, cardiovascular disease mortality, all-cause mortality, and abnormal carotid intima-media thickness (CIMT). Peripheral neuropathy was predominantly associated with standard deviation (SD) and mean amplitude of glycaemic excursions (MAGE).
Conclusions:
The evidence supports the association between diabetes complications and CGM-derived measures of intra-day glycaemic variability. TIR emerged as the most consistent measure, supporting its emerging role in clinical practice. More longitudinal studies and trials are required to confirm these associations, particularly for type 1 diabetes where there are limited data.
Details
- Title
- Complications of diabetes and metrics of glycaemic management derived from continuous glucose monitoring
- Authors
- Michael Yapanis (Author) - The University of MelbourneSteven James (Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - LegacyMaria E Craig (Author) - UNSW AustraliaDavid O'Neal (Author) - The University of MelbourneElif I Ekinci (Corresponding Author) - The University of Melbourne
- Publication details
- Journal of Clinical Endocrinology and Metabolism, Vol.107(6), pp.2221-2236
- Audience
- Professional
- Publisher
- Oxford University Press
- Date published
- 2022
- DOI
- 10.1210/clinem/dgac034
- ISSN
- 1945-7197; 0021-972X
- PMID
- 35094087
- Organisation Unit
- School of Health - Nursing; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99608308702621
- Output Type
- Journal article
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web Of Science research areas
- Endocrinology & Metabolism
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Source: InCites