Introduction and Object: As two key profiles for blood glucose control and complications, the relative contributions of glycosylated hemoglobin (HbA1c) and glycemic variability (GV) to microvascular outcomes are explored in type 1 diabetes mellitus in Diabetes Control and Complications Trial (DCCT) study.

Methods: Measures of GVs included the SD, mean amplitude of glycemic excursions (MAGE), coefficient of variation (CV) within and between quarterly 7-point glucose profiles and HbA1c.The generalized boosted models were used to analysis the relative effects of HbA1c and GV.

Results: Mean HbA1c accounted for 57%-62% /55%-57%for the development/progression of retinopathy, and GV accounted for 38%-43%/43%-57%, even similar in subgroup analysis including gender, age, duration, triglyceride and changes of nephropathy. HbA1c accounted for 46.5% for the occurrence of microalbuminuria, as for GV, 53.5% respectively. MAGE and SD accounted more in patients with duration of more than 10years. GV contributed more in subgroup with serum triglyceride≤55mg/dL and non-deteriorated retinopathy (58%-61%, 59%-67% respectively) in microalbuminuria.

Conclusion: Our finding showed that GV contributed equally as HbA1c, or more for microvascular outcomes in type 1 diabetes, especially for microalbuminuria. Refined and comprehensive blood glucose management would be needed for health care provides.

Disclosure

J. Zhang: None. Z. Song: None. M. Li: None. H. Zhu: None. S. Gao: None. Y. Liu: None.

© 2024 by the American Diabetes Association
2024
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