Glycemic Variability and Its Association with Traditional Glycemic Control Biomarkers in Patients with Type 1 Diabetes: A Cross-Sectional, Multicenter Study.

Glycemic variability (GV) is a novel concept in the assessment of the quality of glycemic control in patients with diabetes, with its importance emphasized in patients with type 1 diabetes. Its adoption in clinical practice emerged with the increased availability of continuous glycemic monitoring systems. The aim of this study is to evaluate the GV in patients with type 1 diabetes mellitus (T1DM) and to assess its associations with other parameters used to evaluate the glycemic control. GV indexes and classical glycemic control markers were analyzed for 147 adult patients with T1DM in a multicentric cross-sectional study. Stable glycemia was associated with a higher time in range (TIR) (78% vs. 63%; < 0.001) and a lower HbA1c (6.8% vs. 7.1%; = 0.006). The coefficient of variation (CV) was reversely correlated with TIR (Spearman's r = -0.513; < 0.001) and positively correlated with hemoglobin A1c (HbA1c) (Spearman's r = 0.349; < 0.001), while TIR was reversely correlated with HbA1c (Spearman's r = -0.637; < 0.001). The composite GV and metabolic outcome was achieved by 28.6% of the patients. Stable glycemia was associated with a lower HbA1c, average and SD of blood glucose, and a higher TIR. A TIR higher than 70% was associated with a lower HbA1c, and SD and average blood glucose. Only 28.6% of the patients with T1DM achieved the composite GV and metabolic outcome, despite 53.7% of them achieving the HbA1c target, emphasizing thus the role of GV in the assessment of the glycemic control.