Beyond HbA1c: Comparing Glycemic Variability and Glycemic Indices in Predicting Hypoglycemia in Type 1 and Type 2 Diabetes

Rama Chandran S 1 , Tay WL 1 , Lye WK 2 , Lim LL 3 , Ratnasingam J 3 , Tan ATB 3 Show all authors , Gardner DSL 1

Affiliations 

  • 1 1 Department of Endocrinology, Singapore General Hospital , Singapore
  • 2 2 Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Medical School , Singapore
  • 3 3 Division of Endocrinology, Department of Internal Medicine, University of Malaya , Kuala Lumpur, Malaysia
Diabetes Technol Ther, 2018 05;20(5):353-362.
PMID: 29688755 DOI: 10.1089/dia.2017.0388

Abstract

BACKGROUND: Hypoglycemia is the major impediment to therapy intensification in diabetes. Although higher individualized HbA1c targets are perceived to reduce the risk of hypoglycemia in those at risk of hypoglycemia, HbA1c itself is a poor predictor of hypoglycemia. We assessed the use of glycemic variability (GV) and glycemic indices as independent predictors of hypoglycemia.

METHODS: A retrospective observational study of 60 type 1 and 100 type 2 diabetes subjects. All underwent professional continuous glucose monitoring (CGM) for 3-6 days and recorded self-monitored blood glucose (SMBG). Indices were calculated from both CGM and SMBG. Statistical analyses included regression and area under receiver operator curve (AUC) analyses.

RESULTS: Hypoglycemia frequency (53.3% vs. 24%, P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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