Is the Consensual Threshold for Defining High Glucose Variability Implementable in Clinical Practice?
figureposted on 2021-06-07, 18:17 authored 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.