Is the Consensual Threshold for Defining High Glucose Variability Implementable in Clinical Practice?

Julla, Jean-Baptiste; Jacquemier, Pauline; Fagherazzi, Guy; Vidal-Trecan, Tiphaine; Juddoo, Vanessa; Jaziri, Asma; Mersel, Hanane; Venteclef, Nicolas et al. · Diabetes Care · 2021

retrospective_cohort · Level III

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Abstract

Estimating glycemic variability (GV) through within-day coefficient of variation (%CV<sub>w</sub>) is recommended for patients with type 1 Diabetes (T1D). High GV (hGV) is defined as %CV<sub>w</sub> > 36%. However, continuous glucose monitoring (CGM) devices provide exclusively total CV (%CV<sub>T</sub>). We aimed to assess consequences of this disparity. We retrospectively calculated both %CV<sub>T</sub> and %CV<sub>w</sub> of consecutive T1D patients from their CGM raw data during 14 days. Patients with hGV with %CV<sub>T</sub> >36% and %CV<sub>w</sub> ≤36% were called the "inconsistent GV group". A total of 104 patients were included. Mean ± SD %CV<sub>T</sub> and %CV<sub>w</sub> were 42.4 ± 8% and 37.0 ± 7.4% respectively (<i>P</i> < 0.0001). Using %CV<sub>T</sub>, 81 patients (73.6%) were classified as having hGV, whereas 59 (53.6%) using %CV<sub>w</sub> (<i>P</i> < 0.0001) corresponding to 22 patients (21%) in the inconsistent GV population. Evaluation of GV through %CV in patients with T1D is highly dependent on the calculation method and then must be standardized.

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