The Effect of Glucose Variability on the Risk of Microvascular Complications in Type 1 Diabetes: Response to Kilpatrick et al.

We have read with interest the article by Kilpatrick et al. (1), which reports the lack of effect of glucose variability on the risk for microvascular complications in type 1 diabetes using the Diabetes Control and Complications Trial database. We are pleased that the authors came to the same conclusions as we did in our examination (2) of this question using the same database. Since Diabetes Control and Complications Trial subjects were studied for differing durations and not all subjects provided complete seven-point glucose samples, how were these factors dealt with in the analysis? Furthermore, what were the reasons to limit the assessment of glucose variability to SD and omit measurements of M value and mean amplitude of glycemic excursion, two established indexes of glucose variability? The authors may wish to reexamine their literature research technique; it appears to be less than rigorous.