Table 3 Potential beneficial measures for addressing GV

Patients with type 1 diabetes

CGM

Reduced GV and improved protection against hypoglycemia

[87,88,89]

Insulin analogues degludec

Minimized morning GV

[91]

Canagliflozin

Improved indices of GV

[92]

Dapagliflozin over 24 weeks

Improved GV without increasing the time spent in the range indicating hypoglycemia

[93]

Empagliflozin as adjunct to insulin

Decreased glucose exposure and variability and increased time in glucose target range

[103]

Combination of basal insulin with ipragliflozin or dapagliflozin

Improved TIR and the mean glucose level

[104]

Low carbohydrate diet

Resulted in more time in euglycemia, less time in hypoglycemia

[108,109,110]

Patients with type 2 diabetes

Dapagliflozin on 24-h

Improved measures of GV

[94]

Once-weekly trelagliptin and once-daily alogliptin

Improved glycemic control and reduced GV without inducing hypoglycemia

[95]

Combination of basal insulin with a GLP-1 RA

Lowered GV and hypoglycemia

[96]

Exenatide once weekly

Improved daily glucose control and reduced GV

[97]

Lixisenatide added to basal insulin

Reduced GV and PPG excursions without increasing the risk of hypoglycemia

[98]

Liraglutide

Lower mean time in hyperglycemia

[99]

Combination of metformin and gemigliptin or sitagliptin

Significantly reduced GV

[100]

Vildagliptin or pioglitazone

Significantly reduced MAGE, glycated hemoglobin and mean plasma glucose levels

[101]

Combination of metformin and vildagliptin or glimepiride

Improved glucose level with a significantly greater reduction in GV and hypoglycemia

[102]

Intensive insulin therapy combined with metformin

Reduced both glucose fluctuation and nocturnal hypoglycemic risk

[105]

Low-carbohydrate high-fat diet

Reduced glycemic fluctuation

[106, 107, 111]

Sequence of food ingestion

Associated with lower post-lunch glucose excursions and lower glucose coefficients of variation

[115]

Aerobic and combined exercise sessions

Reduced glucose levels and GV

[116,117,118]

Short-term exercise training

Improved glycemic control and GV but unaffected oxidative stress

[119, 121]

Frequent interruptions of prolonged sitting

Improved fasting glucose and night-time glycemic variability

[120]

Others

Low glycemic index foods

Reduced the glycemic response and variability and promoted fat oxidation.

[112, 113]

Food order

Reduced glycemic excursions

[114]

Exercise in the fasted and postprandial state

Exercise in the postprandial state after breakfast, but not in the fasted state, decreased glucose excursions

[122]

Aerobic and eccentric exercise

Reduced all the indices of GV

[123]

Immediate post-breakfast physical activity

Improved mean, CV and AUC glucose

[124]