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

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posted on 07.06.2021, 18:17 by Jean-Baptiste Julla, Pauline Jacquemier, Guy Fagherazzi, Tiphaine Vidal-trecan, Vanessa Juddoo, Asma Jaziri, Hanane Mersel, Nicolas Venteclef, Ronan Roussel, Pascale Massin, Aude Couturier, Jean-François Gautier, Jean-Pierre Riveline
Objective: Estimating glucose variability (GV) through within-day coefficient of variation (%CVw) is recommended for patients with type-1 Diabetes (T1D). High-GV (hGV) is defined as %CVw>36%. However, continuous glucose monitoring (CGM) devices provide exclusively total-CV (%CVT). We aimed to assess consequences of this disparity.

Research Design and Methods: We retrospectively calculated both %CVT and %CVW of consecutive T1D patients from their CGM raw data during 14 days. Patients with hGV with %CVT>36% and %CVw≤36% were called the “inconsistent-GV group”.

Results: 104 patients were included. Mean %CVT and %CVw were 42.4+/-8% and 37.0+/-7.4% respectively (p<0.0001). Using %CVT, 81 patients (73.6%) were classified as hGV whereas 59 (53.6%) using %CVW (p<0.0001) corresponding to 22 patients (21%) in the “inconsistent-GV population”.

Conclusions: Evaluation of GV through %CV in patients with T1D is highly dependent on the calculation method and then must be standardized.

Funding

This study was funded by the “Société Francophone du diabète (SFD)” and by ASSERADT (a nonprofit patient association).

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