Fasting blood sugar variation predicts Microvascular complications in diabetes

It was a posthoc analysis of data from ACCORD and VADT trial. In ACCORD, fasting plasma glucose (FPG) was measured 1-3 times/year for up to 84 months in 10,251 individuals. In the VADT, FPG was measured every 3 months for up to 87 months in 1,791 individuals. For fasting glucose, variabilities measured were the coefficient of variation (CV) and average real variability (ARV). The major outcome assessed was the time to either severe nephropathy or retinopathy event and secondary outcomes included each outcome individually. For assessing the association, researchers considered variability measures as time-dependent covariates in Cox proportional hazard models. They conducted a meta-analysis in both the trials to estimate the risk of fasting glucose variability and to assess the heterogenous effects of FPG variability across treatment arms.

Upon analysis of data from both trials, they found that the coefficient of variability and average real variability of fasting plasma glucose was associated with the development of future microvascular outcomes even after adjusting for other risk factors, including measures of average glycemic control. Similarly, Meta-analyses of these two trials also confirmed the association and indicated FPG variation may be more harmful in those with less intensive glucose control.

The authors concluded, "This posthoc analysis indicates that variability of FPG plays a role in, and/or is an independent and readily available marker of, development of microvascular complications in T2D".

For further information:

DOI: https://doi.org/10.1210/clinem/dgaa941