Diabetology International

, Volume 5, Issue 1, pp 36–42

Factors associated with glycemic variability in Japanese patients with diabetes

Authors

  • Chihiro Tanaka
    • Department of Internal MedicineKeio University School of Medicine
    • Department of Internal MedicineKeio University School of Medicine
  • Kumiko Tanaka
    • Department of Internal MedicineKeio University School of Medicine
  • Kinsei Kou
    • Department of Internal MedicineKeio University School of Medicine
  • Masami Tanaka
    • Department of Internal MedicineKeio University School of Medicine
  • Shu Meguro
    • Department of Internal MedicineKeio University School of Medicine
  • Junichiro Irie
    • Department of Internal MedicineKeio University School of Medicine
  • Rie Jo
    • Department of Internal MedicineKeio University School of Medicine
  • Toshihide Kawai
    • Department of Internal MedicineKeio University School of Medicine
  • Hiroshi Itoh
    • Department of Internal MedicineKeio University School of Medicine
Original Article

DOI: 10.1007/s13340-013-0129-8

Cite this article as:
Tanaka, C., Saisho, Y., Tanaka, K. et al. Diabetol Int (2014) 5: 36. doi:10.1007/s13340-013-0129-8

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.

Keywords

Glycemic variabilityGlycated albuminBeta-cell functionAgeType 2 diabetesContinuous glucose monitoring

Abbreviations

CGM

Continuous glucose monitoring

CPR

C-peptide immunoreactivity

GA

Glycated albumin

OGTT

Oral glucose tolerance test

SMBG

Self-monitoring of blood glucose

SD

Standard deviation

MAGE

Mean amplitude of glycemic excursions

NGSP

National Glycohemoglobin Standardization Program

GLP-1

Glucagon-like peptide-1

CSII

Continuous subcutaneous insulin infusion

Copyright information

© The Japan Diabetes Society 2013