Exploring Glycemic Variability in Diabetes

Diabetes is a condition that affects blood sugar levels, leading to chronic hyperglycemia and acute glucose fluctuations. To prevent complications, it is crucial to understand the role of glycemic variability, particularly the fluctuations between peak and nadir. High levels of glucose variability can activate oxidative stress, leading to complications. Glycemic variability refers to fluctuating blood sugar levels that can occur within a day or over multiple days. Studies have shown that high glycemic variability is often associated with inadequate monitoring of blood sugar levels, leading to hypoglycemia. Reducing glycemic variability has several positive effects, including improved psychosocial well-being and quality of life. Monitoring and minimising glycemic variability can be crucial in managing diabetes and improving overall health outcomes.

Individuals with diabetes need to pay close attention to the effects of high glycemic variability on cardiovascular and endothelial systems. High glycemic variability can also lead to cognitive impairment and increase mortality risk in patients with type 2 diabetes and acute myocardial infarction. Monitoring glycemic variability closely can prevent potential complications and ensure optimal health outcomes. The medical term “Time in Range” refers to when a patient’s glucose levels remain within the optimal range of 70-180 mg/DL. Maintaining the time-in-range can effectively decrease hypoglycemic events in patients using continuous glucose monitoring. Failing to maintain time in range can lead to severe consequences, including increased retinopathy, nephropathy, and neuropathy risks.

Glycemic variability and time in the range are essential factors in diabetes management that pose significant risks. Treatment solutions should prioritise time in range, regularly monitoring it. Managing glycemic variability is becoming increasingly crucial in optimal glycemic control. By carefully managing self-monitoring of blood glucose and using new agents to correct hyperglycemia without inducing hypoglycemia, we can reduce the burden of premature mortality and disabling cardiovascular events associated with diabetes mellitus. However, defining glycemic variability remains a challenge due to the difficulties in measuring it and the need for a consensus on the optimal approach to patient management.

For further information and consultation, you can visit KLES Dr Prabhakar Kore Hospital’s Diabetes Centre, Room Number 5. (Phone Contact: 08312551486/ 08312551377) or call the helpline of the Diabetes Centre: Mobile 8762015999.

Dr. Mallikarjun V Jali​
Chief Diabetologist & Professor of Diabetology (Med)​
MD, FRCP, FICP, FGSI, D.Litt