Is the Consensual Threshold for Defining High Glucose Variability Implementable in Clinical Practice?

Diabetes Care
Jean-Baptiste JullaJean-Pierre Riveline

Abstract

Estimating glycemic variability (GV) through within-day coefficient of variation (%CVw) is recommended for patients with type 1 Diabetes (T1D). High GV (hGV) is defined as %CVw > 36%. However, continuous glucose monitoring (CGM) devices provide exclusively total CV (%CVT). We aimed to assess consequences of this disparity. We retrospectively calculated both %CVT and %CVw of consecutive T1D patients from their CGM raw data during 14 days. Patients with hGV with %CVT >36% and %CVw ≤36% were called the "inconsistent GV group". A total of 104 patients were included. Mean ± SD %CVT and %CVw were 42.4 ± 8% and 37.0 ± 7.4% respectively (P < 0.0001). Using %CVT, 81 patients (73.6%) were classified as having hGV, whereas 59 (53.6%) using %CVw (P < 0.0001) corresponding to 22 patients (21%) in the inconsistent GV population. Evaluation of GV through %CV in patients with T1D is highly dependent on the calculation method and then must be standardized.

References

Sep 24, 2004·Diabetes/metabolism Research and Reviews·Ulrik Pedersen-BjergaardBirger Thorsteinsson
May 22, 2016·Diabetes Care·Boris Kovatchev, Claudio Cobelli
Apr 25, 2018·Diabetes Technology & Therapeutics·Suresh Rama ChandranDaphne S L Gardner
Jun 20, 2018·Diabetes Technology & Therapeutics·David Rodbard
Jun 21, 2019·Diabetes Technology & Therapeutics·Ana María GómezFabian Mauricio León Vargas

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