Glycemic variability: The third component of the dysglycemia in diabetes. Is it important? how to measure it?

Abstract

The dysglycemia of diabetes includes two components: (1) sustained chronic hyperglycemia that exerts its effects through both excessive protein glycation and activation of oxidative stress and (2) acute glucose fluctuations. Glycemic variability seems to have more deleterious effects than sustained hyperglycemia in the development of diabetic complications as both upward (postprandial glucose increments) and downward (interprandial glucose decrements) changes activate the oxidative stress. For instance, the urinary excretion rate of 8-iso-PGF2a, a reliable marker of oxidative stress, was found to be strongly, positively correlated (r = 0.86, p