Glycaemic variability in diabetes: clinical and therapeutic implications

Lancet Diabetes Endocrinol. 2019 Mar;7(3):221-230. doi: 10.1016/S2213-8587(18)30136-0. Epub 2018 Aug 13.


Glycaemic variability is an integral component of glucose homoeostasis. Although it has not yet been definitively confirmed as an independent risk factor for diabetes complications, glycaemic variability can represent the presence of excess glycaemic excursions and, consequently, the risk of hyperglycaemia or hypoglycaemia. Glycaemic variability is currently defined by a large and increasing number of metrics, representing either short-term (within-day and between-day variability) or long-term glycaemic variability, which is usually based on serial measurements of HbA1c or other measures of glycaemia over a longer period of time. In this Review, we discuss recent evidence examining the association between glycaemic variability and diabetes-related complications, as well as non-pharmacological and pharmacological strategies currently available to address this challenging aspect of diabetes management.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism*
  • Blood Glucose Self-Monitoring
  • Diabetes Complications / metabolism*
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / metabolism*
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hyperglycemia / metabolism*
  • Hypoglycemia / chemically induced
  • Hypoglycemia / metabolism*
  • Hypoglycemic Agents / therapeutic use
  • Monitoring, Ambulatory


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