Effect of glucose variability on the long-term risk of microvascular complications in type 1 diabetes

Eric S. Kilpatrick, Alan S. Rigby, Stephen Atkin

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

OBJECTIVE - This study analyzed data from the Epidemiology of Diabetes Interventions and Complications (EDIC) study to see whether longer-term follow-up of Diabetes Control and Complications Trial (DCCT) patients reveals a role for glycemic instability in the development of microvascular complications. RESEARCH DESIGN AND METHODS - The mean area under the curve glucose and the within-day glucose variability (SD and mean amplitude of glycemic excursions [MAGE]) during the DCCT were assessed to see whether they contributed to the risk of retinopathy and nephropathy by year 4 of the EDIC. RESULTS - Logistic regression analysis showed that mean glucose during the DCCT and mean A1C during EDIC were independently predictive of retinopathy (each P < 0.001) as well as A1C during EDIC of nephropathy (P = 0.001) development by EDIC year 4. Glucose variability did not add to this (all P > 0.25 using SD or MAGE). CONCLUSIONS - Glucose variability in the DCCT did not predict the development of retinopathy or nephropathy by EDIC year 4.

Original languageEnglish
Pages (from-to)1901-1903
Number of pages3
JournalDiabetes Care
Volume32
Issue number10
DOIs
Publication statusPublished - Oct 2009
Externally publishedYes

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Diabetes Complications
Type 1 Diabetes Mellitus
Glucose
Epidemiology
Area Under Curve
Research Design
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Effect of glucose variability on the long-term risk of microvascular complications in type 1 diabetes. / Kilpatrick, Eric S.; Rigby, Alan S.; Atkin, Stephen.

In: Diabetes Care, Vol. 32, No. 10, 10.2009, p. 1901-1903.

Research output: Contribution to journalArticle

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AB - OBJECTIVE - This study analyzed data from the Epidemiology of Diabetes Interventions and Complications (EDIC) study to see whether longer-term follow-up of Diabetes Control and Complications Trial (DCCT) patients reveals a role for glycemic instability in the development of microvascular complications. RESEARCH DESIGN AND METHODS - The mean area under the curve glucose and the within-day glucose variability (SD and mean amplitude of glycemic excursions [MAGE]) during the DCCT were assessed to see whether they contributed to the risk of retinopathy and nephropathy by year 4 of the EDIC. RESULTS - Logistic regression analysis showed that mean glucose during the DCCT and mean A1C during EDIC were independently predictive of retinopathy (each P < 0.001) as well as A1C during EDIC of nephropathy (P = 0.001) development by EDIC year 4. Glucose variability did not add to this (all P > 0.25 using SD or MAGE). CONCLUSIONS - Glucose variability in the DCCT did not predict the development of retinopathy or nephropathy by EDIC year 4.

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