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Table 2 The effects of GV on adverse clinical outcomes

From: Glycemic variability: adverse clinical outcomes and how to improve it?

Types of GV

Subjects

Effects

References

Short-term GV

 TIR

3262 patients with type 2 diabetes

Inversely correlated with DR

[27]

 Day-to-day FPG variability

7637 patients with type 2 diabetes

Increased risks of severe hypoglycemia and all-cause mortality

[29]

 MAGE

417 patients with ACS

Predicted the poor prognosis for patients with acute coronary syndrome

[32]

 Mean daily δ blood glucose

160 patients with transcatheter aortic valve implantation

Increased the risk of macrovascular complications

[35]

 MAGE

204 patients with type 2 diabetes

Increased coronary artery disease severity

[36]

 MAGE

50 patients with dysglycemia

Positively correlated with coronary artery spasm

[37]

 MAGE

2666 hospitalized patients with CAD

Positively associated with poor prognosis in CAD patients

[38]

 Incremental glucose peak

2758 patients with type 2 diabetes

Positively associated with aortic stiffness and maladaptive carotid remodeling

[39]

 MAGE

40 patients with type 1 or type 2 diabetes

Positively associated with DPN

[51]

 LBGI and HBGI

140 patients with type 2 diabetes

Increased the risk of hypoglycemia

[66]

 LBGI

73 patients with type 1 diabetes

Increased the risk of hypoglycemia

[67]

 Day‐to‐day fasting SMBG variability

1221 patients with type 1 or type 2 diabetes

Increased the risk of overall symptomatic, nocturnal symptomatic and severe hypoglycemia

[68]

 CONGA, MAG and MAGE

83 patients with type 2 diabetes

Predicted the nocturnal hypoglycemia

[69]

 Mean blood glucose

62 patients with type 2 diabetes

Predicted the hypoglycemia

[70]

 CV within a day

6101 critically ill adults

Increased the risk of mortality and hypoglycemia

[72]

 IQR

28,353 patients with type 2 diabetes

Increased the risk of mortality

[73]

Long-term GV

 Visit-to-visit variability of FPG

654 patients with type 2 diabetes

Predicted the renal composite outcome

[31]

 SD during initial hospitalization

327 patients with diabetes and ACS

Predicted the midterm macrovascular complications

[40]

 Visit-to-visit variability of FPG

53,607 patients initially without CVD

Increased the risk of CVD and all-cause mortality

[41]

 Visit-to-visit variability of FPG

1791 patients with type 2 diabetes

Positively associated with the risk of CVD

[42]

 Visit-to-visit variability of FPG

455 patients with type 2 diabetes

Independently associated with annualized changes in left cardiac structure and function

[43]

 Visit-to-visit variability of FPG

3769 patients initially without CVD

Increased the risk of incident diabetes, CVD and mortality

[44]

 Visit-to-visit variability of FPG

3,211,319 patients without diabetes

Independently associated with CVD and mortality

[45]

 Visit-to-visit variability of HbA1c

632 patients with type 2 diabetes

Predicted the additive risk for CVD incidence

[46]

 Visit-to-visit variability of HbA1c

972 patients with type 2 diabetes

Positively associated with macrovascular complication

[47]

 Visit-to-visit variability of HbA1c

201 patients with type 2 diabetes

Potentially predicted the progression of HFpEF

[48]

 Visit-to-visit variability of HbA1c

902 patients with type 2 diabetes and heart failure

Predicted all-cause mortality

[49]

 Visit-to-visit variability of FPG

2773 patients with type 2 diabetes

Positively correlated with DPN

[52]

 Visit-to-visit variability of FPG

36,152 patients with type 2 diabetes

Predicted the risk of DPN

[53]

 Visit-to-visit variability of HbA1c

563 patients with type 2 diabetes

Positively associated the risk of DPN

[54]

 Visit-to-visit variability of HbA1c

220 patients with type 1 diabetes

Positively associated the risk of DPN

[55]

 Visit-to-visit variability of HbA1c

223 patients with type 2 diabetes

Positively associated with the severity of DPN

[56]

 Visit-to-visit variability of HbA1c

451 patients with type 1 diabetes

Increased the risk of DR

[58]

 Visit-to-visit variability of HbA1c

895 patients with type 2 diabetes

Positively associated with progression of DN

[60]

 Visit-to-visit variability of HbA1c

4231 patients with type 2 diabetes

Increased the risk of DKD

[61]

 Visit-to-visit variability of HbA1c

1383 patients with type 2 diabetes

Increased the deterioration of renal function

[62]

 Visit-to-visit variability of HbA1c

388 patients with type 2 diabetes

Positively associated with renal progression

[64]

 Visit-to-visit variability of FPG

3569 patients with type 2 diabetes

Increased the risk of mortality

[74]

 Visit-to-visit variability of HbA1c

15,733 patients with type 2 diabetes

Strongly predicted all-cause mortality

[75]

 Visit-to-visit variability of FPG

1136 patients with type 2 diabetes

Predicted all-cause mortality

[76]

 Visit-to-visit variability of FPG

42,418 hypertensive patients

Increased the risk of mortality

[77]

 CV and SD during hospitalization

20,303 hospitalized patients

Increased longer hospitalization and mortality

[78]

 Visit-to-visit variability of HbA1c

6048 patients with type 1 diabetes

Increased mortality and earlier hospital admission

[79]

 Visit-to-visit variability of HbA1c

58,832 patients with type 2 diabetes

Positively associated with overall mortality and emergency hospitalization

[80]

 Visit-to-visit variability of HbA1c

9483 patients with type 2 diabetes

Predicted all-cause mortality

[81]

 Visit-to-visit variability of HbA1c

837 patients with type 2 diabetes

Predicted depressive symptoms

[83]

 Visit-to-visit variability of FPG

3307 adults before the onset of diabetes

Increased the risk of cognitive function

[84]

 Visit-to-visit variability of HbA1c

2640 patients with type 1 or type 2 diabetes

Increased the potential risk of later tumorigenesis

[86]

  1. GV, glycemic variability; TIR, time in range; DR, diabetic retinopathy; FPG, fasting plasma glucose; MAGE, mean amplitude of glycemic excursions; ACS, acute coronary syndrome; CAD, coronary artery disease; LBGI, low blood glucose index; HBGI, high blood glucose index; SMBG, self‐monitored blood glucose; CONGA, continuous overlapping net glycemic action; MAG, mean absolute glucose; CV, coefficient of variation; IQR, interquartile ranges; CVD, cardiovascular disease; HFpEF, heart failure with preserved ejection fraction; DPN, diabetes peripheral neuropathy; DR, diabetic retinopathy; DN, diabetic nephropathy; DKD, diabetic kidney disease; SD, standard deviation