Unit of Cardiac Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
Unit of Endocrinology and Diabetes Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
Diabetes Metab Res Rev. 2018 Nov;34(8):e3047. doi: 10.1002/dmrr.3047. Epub 2018 Aug 9.
Diabetes mellitus represents a major risk factor for the development of coronary artery disease and other vascular complications. Glycated haemoglobin, fructosamine, and fasting blood glucose levels are partial parameters to exhaustively describe patient dysglycemic status. Thus, recently the new concept of glycemic variability has emerged, including information about two major aspects: the magnitude of blood glucose excursions (from nadir to peak, thus lower and higher spikes) and the time intervals in which these fluctuations occur. Despite the lack of consensus regarding the most appropriate definition and tools for its assessment, glycemic variability seems to have more deleterious effects than sustained hyperglycemia in the pathogenesis of diabetic cardiovascular complications. This manuscript aimed to review the most recent evidence on glycemic variability and its potential use in everyday clinical practice to identify diabetic patients at higher risk of cardiovascular complications and thus needing stricter monitoring and treatment.
糖尿病是冠状动脉疾病和其他血管并发症发展的主要危险因素。糖化血红蛋白、果糖胺和空腹血糖水平是描述患者血糖状态的部分参数。因此，最近出现了血糖变异性的新概念，包括关于两个主要方面的信息：血糖波动的幅度（从最低点到最高点，因此是较低和较高的峰值）和发生这些波动的时间间隔。尽管对于其评估的最合适定义和工具缺乏共识，但血糖变异性在糖尿病心血管并发症的发病机制中的有害影响似乎超过了持续高血糖。本文旨在综述血糖变异性的最新证据及其在日常临床实践中的潜在应用，以识别心血管并发症风险较高的糖尿病患者，从而需要更严格的监测和治疗。
