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      Correlation Between Glycemic Variability and Diabetic Complications: A Narrative Review

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          Abstract

          Diabetes mellitus is a metabolic disorder with a complex etiology in which glycemic dynamics are disturbed and the body is unable to maintain the process of glucose homeostasis through the pancreas. Persistent symptoms of high blood glucose or low blood glucose may lead to diabetic complications, such as neuropathy, nephropathy, retinopathy, and cardiovascular diseases. Glycemic variability which can represent the presence of excessive glycemic excursions is an indicator for evaluating glucose homoeostasis. Limiting glycemic variability has gradually become an emerging therapeutic target in improve diabetes metabolism and prevent associated complications. This article reviews the progress of research on the various quantifiable parameters of glycemic variability and their relationships with vascular lesions and mechanisms.

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          Most cited references77

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          Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future.

          Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin affects magnitude of β-cell response. If insulin resistance is present, β cells maintain normal glucose tolerance by increasing insulin output. Only when β cells cannot release sufficient insulin in the presence of insulin resistance do glucose concentrations rise. Although β-cell dysfunction has a clear genetic component, environmental changes play an essential part. Modern research approaches have helped to establish the important role that hexoses, aminoacids, and fatty acids have in insulin resistance and β-cell dysfunction, and the potential role of changes in the microbiome. Several new approaches for treatment have been developed, but more effective therapies to slow progressive loss of β-cell function are needed. Recent findings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse effects of these interventions. However, additional long-term studies of drugs and bariatric surgery are needed to identify new ways to prevent and treat type 2 diabetes and thereby reduce the harmful effects of this disease. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials

            This study evaluated the association of time in range (TIR) of 70-180 mg/dL (3.9-10 mmol/L) with the development or progression of retinopathy and development of microalbuminuria using the Diabetes Control and Complications Trial (DCCT) data set in order to validate the use of TIR as an outcome measure for clinical trials.
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              Association of Time in Range, as Assessed by Continuous Glucose Monitoring, With Diabetic Retinopathy in Type 2 Diabetes

              Continuous glucose monitoring (CGM) has provided new measures of glycemic control that link to diabetes complications. This study investigated the association between the time in range (TIR) assessed by CGM and diabetic retinopathy (DR).
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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                ijgm
                International Journal of General Medicine
                Dove
                1178-7074
                21 July 2023
                2023
                : 16
                : 3083-3094
                Affiliations
                [1 ]Department of Endocrinology, Gusu School, Nanjing Medical University, The First People’s Hospital of Kunshan , Kunshan, 215300, People’s Republic of China
                [2 ]Guangzhou Laboratory , Guangzhou, 510005, People’s Republic of China
                [3 ]Hangzhou Kang Ming Information Technology Co., Ltd , Hangzhou, 310000, People’s Republic of China
                Author notes
                Correspondence: Shao Zhong, Department of Endocrinology, Gusu School, Nanjing Medical University, The First People’s Hospital of Kunshan , Kunshan, 215300, People’s Republic of China, Tel +86 13328056828, Email drzhong@163.com
                Hongying Liu, Hangzhou Kang Ming Information Technology Co., Ltd , Hangzhou, 310000, People’s Republic of China, Email hongyingliu@91jkys.com
                Author information
                http://orcid.org/0000-0002-8573-8535
                Article
                418520
                10.2147/IJGM.S418520
                10368016
                eb29a7de-8fee-4cc8-805d-b11dd34116f9
                © 2023 Huang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 25 April 2023
                : 11 July 2023
                Page count
                Figures: 0, Tables: 2, References: 77, Pages: 12
                Funding
                Funded by: Suzhou Science and Technology Project;
                This work was supported by Suzhou Science and Technology Project (No: SLT2021006).
                Categories
                Review

                Medicine
                diabetes mellitus,glycemic variability,glycemic variability parameters,vascular lesions of diabetes mellitus

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