PMID- 27049155
OWN - NLM
STAT- MEDLINE
DCOM- 20161005
LR  - 20221207
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 110
IP  - 2
DP  - 2015 Nov
TI  - How well do glucose variability measures predict patient glycaemic outcomes 
      during treatment intensification in type 2 diabetes?
PG  - 234-40
AB  - AIM: Despite links to clinical outcomes in patients with type 2 diabetes mellitus 
      (T2DM), the clinical utility of glycaemic variability (GV) measures is unknown. 
      We evaluated the correlation between baseline GV, and glycated haemoglobin 
      (HbA1c) attainment and hypoglycaemic events during treatment intensification in a 
      large group of patients. METHODS: Patient-level data from six 24-week clinical 
      trials of T2DM patients undergoing treatment intensification with basal insulin 
      or comparators (N = 1699) were pooled. Baseline GV measures included standard 
      deviation (SD), mean amplitude of glycaemic excursions (MAGE), mean absolute 
      glucose (MAG), coefficient of variation (CV), high blood glucose index (HBGI), 
      and low blood glucose index (LBGI) and were correlated with HbA1c change and 
      hypoglycaemic events. RESULTS: All mean GV measures, excluding CV which worsened, 
      improved significantly from baseline to Week 24, with the largest proportional 
      reduction obtained for HBGI (-65.5%). When assessed as mean individual percentage 
      changes, only HBGI improved significantly. Baseline GV correlated positively with 
      Week 24 HbA1c for SD, MAGE, and HBGI. Baseline HBGI and CV correlated negatively 
      and positively, respectively, with Week 24 HbA1c change. Correlations also 
      existed between most baseline GV measures and age, body mass index, Week 24 
      fasting plasma glucose, Week 24 postprandial plasma glucose, and hypoglycaemic 
      events; statistical significance depended on the specific measure. CONCLUSIONS: 
      Pre-treatment GV is associated with glycaemic outcomes in T2DM patients 
      undergoing treatment intensification over 24 weeks. HBGI might be the most robust 
      predictor, warranting validation in dedicated prospective studies or randomized 
      trials to assess the predictive value of measuring GV.
FAU - Inzucchi, Silvio E
AU  - Inzucchi SE
FAU - Umpierrez, Guillermo
AU  - Umpierrez G
FAU - DiGenio, Andres
AU  - DiGenio A
FAU - Zhou, Rong
AU  - Zhou R
FAU - Kovatchev, Boris
AU  - Kovatchev B
LA  - eng
PT  - Corrected and Republished Article
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
CRF - Diabetes Res Clin Pract. 2015 Apr;108(1):179-86. PMID: 25661664
MH  - Aged
MH  - Blood Glucose/*analysis
MH  - Diabetes Mellitus, Type 2/*blood/drug therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Randomized Controlled Trials as Topic/*methods
MH  - Time Factors
EDAT- 2016/04/07 06:00
MHDA- 2016/10/07 06:00
CRDT- 2016/04/07 06:00
PHST- 2016/04/07 06:00 [entrez]
PHST- 2016/04/07 06:00 [pubmed]
PHST- 2016/10/07 06:00 [medline]
AID - S0168-8227(15)00366-6 [pii]
AID - 10.1016/j.diabres.2015.09.002 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2015 Nov;110(2):234-40. doi: 
      10.1016/j.diabres.2015.09.002.