Assessment of the association between glycemic variability and diabetes-related complications in type 1 and type 2 diabetes

Diabetes Res Clin Pract. 2014 Sep;105(3):273-84. doi: 10.1016/j.diabres.2014.06.007. Epub 2014 Jun 23.


Chronic hyperglycemia is the main risk factor for the development of diabetes-related complications in both type 1 and type 2 diabetes, but it is thought that frequent or large glucose fluctuations may contribute independently to diabetes-related complications. A systematic literature review was performed using the PubMed, EMBASE and Cochrane Library databases with searches limited to studies published from June 2002 to March 2014, in English and including ≥50 patients. Twenty eight articles were included in the final review. Eighteen studies reported the association between glucose variability and diabetes-related complications exclusively in type 2 diabetes. A positive association between increased variability and microvascular complications and coronary artery disease was consistently reported. Associations between glucose variability and other macrovascular complications were inconsistent in type 2 diabetes. Seven studies examined the association between glucose variability and complications exclusively in type 1 diabetes. Increased glucose variability appears to play a minimal role in the development of micro- and macrovascular complications in type 1 diabetes. Consistent findings suggest that in type 2 diabetes glucose variability is associated with development of microvascular complications. The role of increased glucose variability in terms of microvascular and macrovascular complications in type 1 diabetes is less clear; more data in are needed.

Keywords: Glycemic variability; Macrovascular complications; Microvascular complications.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Blood Glucose / analysis*
  • Blood Glucose / metabolism
  • Coronary Artery Disease / etiology
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Nephropathies / etiology
  • Diabetic Retinopathy / etiology
  • Female
  • Humans
  • Hyperglycemia / complications*
  • Male
  • Oxidative Stress
  • Risk Factors


  • Blood Glucose