Diabetology International

, Volume 5, Issue 1, pp 36–42

Factors associated with glycemic variability in Japanese patients with diabetes

  • Chihiro Tanaka
  • Yoshifumi Saisho
  • Kumiko Tanaka
  • Kinsei Kou
  • Masami Tanaka
  • Shu Meguro
  • Junichiro Irie
  • Rie Jo
  • Toshihide Kawai
  • Hiroshi Itoh
Original Article

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 variability Glycated albumin Beta-cell function Age Type 2 diabetes Continuous 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

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Copyright information

© The Japan Diabetes Society 2013

Authors and Affiliations

  • Chihiro Tanaka
    • 1
  • Yoshifumi Saisho
    • 1
  • Kumiko Tanaka
    • 1
  • Kinsei Kou
    • 1
  • Masami Tanaka
    • 1
  • Shu Meguro
    • 1
  • Junichiro Irie
    • 1
  • Rie Jo
    • 1
  • Toshihide Kawai
    • 1
  • Hiroshi Itoh
    • 1
  1. 1.Department of Internal MedicineKeio University School of MedicineTokyoJapan

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