'Glycaemic variability': a new therapeutic challenge in diabetes and the critical care setting

Diabetic Medicine : a Journal of the British Diabetic Association
Antonio Ceriello, M A Ihnat

Abstract

Much attention has been paid recently to the possibility that oscillating glucose may superimpose on glycated haemoglobin (HbA(1c)) in determining the risk for diabetes complications. Furthermore, recent evidence suggests that glucose variability, particularly if accompanied by frequent hypoglycaemic episodes, may adversely alter the prognosis of acutely ill patients. In vitro and animal studies confirm that oscillating glucose is more dangerous than stable constant high glucose, particularly in activating the pathways involved in the pathogenesis of diabetes complications. The production of free radicals, accompanied by an insufficient increase in intracellular antioxidant defences, seems to account for this phenomenon. In humans, studies also confirm that fluctuating glucose levels produce an increase in free radicals as well as endothelial dysfunction, and that these changes are greater than those produced by stable high glucose. Avoiding glucose fluctuations in diabetic patients and in critically ill patients seems to be an emerging therapeutic challenge.

References

Sep 30, 1993·The New England Journal of Medicine·UNKNOWN Diabetes Control and Complications Trial Research GroupC Siebert
Oct 12, 2001·American Journal of Physiology. Endocrinology and Metabolism·A RissoA Ceriello
Jul 24, 2003·JAMA : the Journal of the American Medical Association·Jean-Louis ChiassonUNKNOWN STOP-NIDDM Trial Research Group
Sep 3, 2003·Biochemical and Biophysical Research Communications·Kosuke AzumaMasako Mitsumata
Dec 17, 2003·The Journal of Trauma·Amalia CochranEarl C Downey
Apr 29, 2004·American Journal of Physiology. Renal Physiology·T S PolhillC A Pollock
Jun 25, 2004·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Vijay SrinivasanVinay Nadkarni
Jan 13, 2005·The Journal of Pediatrics·Edward Vincent Faustino, Michael Apkon
Dec 24, 2005·The New England Journal of Medicine·David M NathanUNKNOWN Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research
Feb 3, 2006·Diabetes/metabolism Research and Reviews·Ludovica PiconiAntonio Ceriello
Apr 13, 2006·JAMA : the Journal of the American Medical Association·Louis MonnierClaude Colette
Apr 13, 2006·JAMA : the Journal of the American Medical Association·Michael Brownlee, Irl B Hirsch
Aug 5, 2006·Arteriosclerosis, Thrombosis, and Vascular Biology·Kosuke AzumaHirotaka Watada
Sep 5, 2006·Diabetes/metabolism Research and Reviews·S Del GuerraP Marchetti
Sep 26, 2006·Biochemical and Biophysical Research Communications·Atsuko TanakaHirotaka Watada
Feb 23, 2007·Nature Clinical Practice. Endocrinology & Metabolism·Lies LangoucheGreet Van den Berghe
May 18, 2007·Biochemical and Biophysical Research Communications·Tomoya MitaHirotaka Watada
Jan 17, 2008·The Journal of Clinical Endocrinology and Metabolism·Katherine EspositoDario Giugliano
Feb 27, 2008·Circulation·Prakash DeedwaniaUNKNOWN American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism
May 23, 2008·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Eliotte HirshbergHeather Van Duker
Jul 4, 2008·Critical Care Medicine·Naeem A AliJean-Charles Preiser
Sep 12, 2008·The New England Journal of Medicine·Rury R HolmanDavid R Matthews

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Citations

Aug 21, 2012·Current Diabetes Reports·Masakazu HiroseKatie Weinger
Jun 28, 2011·Diabetes Technology & Therapeutics·F Javier Ampudia-BlascoJuan F Ascaso
Aug 26, 2011·Diabetes Technology & Therapeutics·Geremia B BolliEllie S Strock
Oct 6, 2012·Diabetes Technology & Therapeutics·Stein Olav SkrøvsethGunnar Hartvigsen
Feb 1, 2011·Therapeutic Advances in Endocrinology and Metabolism·Luz Marina Prieto-Sanchez
May 16, 2013·Trials·Stein Olav SkrøvsethRagnar M Joakimsen
Oct 12, 2012·PloS One·Alexander N PisarchikLiudmila A Pisarchyk
Aug 21, 2013·Indian Journal of Endocrinology and Metabolism·Surabhi Venkata Satya KrishnaKirtikumar D Modi
Dec 10, 2013·International Journal of Endocrinology·M G DalfràA Lapolla
May 27, 2014·Journal of Endocrinological Investigation·Ting-song LiuJian-bin Gong
Aug 3, 2014·Translational Stroke Research·Emmanuel I González-MorenoFernando Góngora-Rivera
May 9, 2012·Neurochemical Research·Vincenzo C RussoFergus J Cameron
Mar 6, 2012·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Roger MazzeOded Langer
Aug 30, 2014·Expert Opinion on Drug Safety·Antonio CerielloFrancesco Rossi
Apr 23, 2016·Diabetes Research and Clinical Practice·Katarína KuricováKateřina Kaňková
May 23, 2012·Vascular Pharmacology·Antonio Ceriello
Jul 27, 2010·Diabetic Medicine : a Journal of the British Diabetic Association·E S KilpatrickS L Atkin
Sep 27, 2013·Diabetes, Obesity & Metabolism·F Cavalot
Feb 19, 2013·Diabetic Medicine : a Journal of the British Diabetic Association·A J DawsonE S Kilpatrick
May 12, 2015·Journal of Diabetes and Its Complications·Hae Kyung YangJae Hyoung Cho
Mar 10, 2015·Diabetes Technology & Therapeutics·Stein Olav SkrøvsethRagnar M Joakimsen

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