The clinical significance and assessment methods of glucose fluctuation / 中国实用内科杂志

ABSTRACT

More and more evidence shows that glucose fluctuation,independent of HbA1c,may play a significant role in the risk for diabetes complications.The purpose of this article is to introduce the assessment of glycemic fluctuation in four aspects,such as within-day blood glucose excursions,day-to-day blood glucose excursions,postprandial blood glucose excursions,and the risk of serious hypoglycemia.The indexes for assessment of within-day blood glucose excursions contain standard deviation of blood glucose(SDBG),time percentage of blood glucose excursions in a certain range,area under the curve or frequency distribution,the largest amplitude of glycemic excursions(LAGE),M-value,and mean amplitude of glycemic excursions(MAGE);the indexes for assessment of day-to-day blood glucose excursions contain fasting plasma glucose-coefficient variation(FPG-CV),and absolute means of daily differences(MODD);the indexes for assessment of postprandial blood glucose excursions contain mean indices of meal excursions(MIME) and increase area under the curve(IAUC);the indexes for assessment of the risk of serious hypoglycemia contain low blood glucose index(LBGI).Rational choices should be made according to the feature of every index and the aim of assessment in Clinicians.