Glucose variability, HbA1c and microvascular complications

Rev Endocr Metab Disord. 2016 Mar;17(1):103-10. doi: 10.1007/s11154-016-9347-2.


Microvascular complications in diabetes are associated with poor long-term diabetes control as measured by HbA1c levels. Glucose fluctuations are related to oxidative stress, endothelial dysfunction, and inflammation, factors traditionally associated with the pathogenesis of vascular damage. Glucose variability has been associated with macrovascular disease in some studies but any association with microvascular disease remains controversial. This overview summarizes recent findings in the field of glucose variability and its possible relationship with retinopathy, nephropathy and neuropathy. It is concluded that randomized prospective follow-up trials could possibly help estimate whether short-term glucose variability should be considered as an independent risk factor for microvascular complications in diabetes.

Keywords: Glucose variability; HbA1c variability; Microvascular complications; Type 1 and Type 2 diabetes.

Publication types

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

MeSH terms

  • Blood Glucose / metabolism*
  • Diabetic Angiopathies / metabolism*
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Microvessels / pathology*


  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human