GLYCEMIC VARIABILITY AS A THERAPEUTIC TARGET IN THE TREATMENT OF PATIENTS WITH TYPE 2 DIABETES MELLITUS


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Abstract

To date, accumulated data suggest that the use of glycemic parameters in conjunction with the glycated hemoglobin levels and other traditional risk factors can improve the accuracy of prediction of the development of vascular complications and hypoglycemia in diabetes mellitus (DM). Assessment of glycemic variability is the most promising approach to the evaluation of the effectiveness of diabetes control, and its reduction can be considered as one of the important therapeutic targets in the treatment of DM [34]. As a consequence, more and more attention is paid to the evaluation of impact of various glucose-lowering drugs on the parameters of glycemic variability, in particular dipeptidyl peptidase-4 inhibitors, which have glucose-dependent effect on the function of pancreatic β- and alpha-cells.

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About the authors

A. S Ametov

Email: endocrin@mtu-net.ru
SBEI FPE "Russian Medical Academy of Postgraduate Education" of RMPH MD, Prof., Head of the Department of Endocrinology and Diabetology Moscow

N. A Chernikova

SBEI FPE "Russian Medical Academy of Postgraduate Education" of RMPH Moscow

T. Yu Demidova

SBEI FPE "Russian Medical Academy of Postgraduate Education" of RMPH Moscow

P. K Nazhmutdinova

LLC "Novartis Pharma" Moscow

References

  1. Holman R.R., Paul S.K., Bethel M.A., Matthews D.R., Neil H.A. 10-year follow-up of intensive glucose control in type 2 diabetes. N. Engl. J. Med. 2008;359:1577-89.
  2. Richard M. Bergenstal Glycemic Variability and Diabetes Complications: Does It Matter? Simply Put, There Are Better Glycemic Markers! Diabetes Care. 2015;38:1615-21.
  3. Irl B. Hirsch. Glycemic Variability and Diabetes Complications: Does It Matter? Of Course It Does! Diabetes Care. 2015;38:1610-14.
  4. Ceriello А., Ihnat M.A. Ihnat 'Glycaemic variability': a new therapeutic challenge in diabetes and the critical care setting. Diabet. Med. 2010;27:862-67.
  5. Bonora E., Calcaterra F., Lombardi S., Bonfante N., Formentini G., Bonadonna R.C., Muggeo M. Plasma Glucose Levels Throughout the Day and HbA1c Interrelationships in Type 2 Diabetes. Diabetes Care. 2001;24:2023-29.
  6. Zenari L., Marangoni A. What are the preferred strategies for control of glycaemic variability in patients with type 2 diabetes mellitus. Diabetes Obes. Metab. 2013;15(s2):17-25.
  7. Derr R., Garrett E., Stacy G.A., Saudek C.D. Is HbA1c affected by Glycemic Instability? Diabetes Care. 2003;26:2728-33.
  8. Nalysnyk L., Hernandez-Medina М., Krishnara jah G. Glycaemic variability and complications in patients with diabetes mellitus:evidence from a systematic review of the literature. Diabetes Obes. Metab. 2010;12(4):288-98.
  9. Monnier L, Colette C. Glycemic variability: should we and can we prevent it? Diabetes Care 2008;31(Suppl. 2):150-154.
  10. Quagliaro L., Piconi L., Assaloni R., Martinelli L., Motz E., Ceriello A. Intermittent High Glucose Enhances Apoptosis Related to Oxidative Stress in Human Umbilical Vein Endothelial Cells: The Role of Protein Kinase C and NAD(P) H-Oxidase Activation. Diabetes. 2003;52(11):2795-804.
  11. Ceriello A., Esposito K., Piconi L., Ihnat M.A., Thorpe J.E., Testa R., Boemi M., Giugliano D. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes. 2008;57:1349-54.
  12. Penckofer S., Quinn L., Byrn M., Ferrans C., Miller M., Strange P. Does Glycemic Variability Impact Mood and Quality of Life. Diabet. Technol. Ther. 2012;14(4):303-10.
  13. Ceriello A. Postprandial hyperglycemia and diabetes complications: is it time to treat? Diabetes. 2005;54:1-7.
  14. Balkau B., Hu G., Qiao Q., Tuomilehto J., Borch-Johnsen K.,Pyörala K., DECODE Study Group; European Diabetes Epidemiology Group. Prediction of the risk of cardiovascular mortality using a score that includes glucose as a risk factor. The DECODE Study. Diabetologia. 2004;47:2118-28.
  15. Chiasson J.L., Josse R.G., Gomis R., Hanefeld M., Karasik A., Laakso M. STOP-NIDDM Trial Research Group. Acarbose treatment and the risk of cardiovascular disease andhyper-tension in patients with impaired glucose tolerance:the STOP-NIDDM trial. JAMA. 2003; 290:486-94.
  16. Raz I., Wilson P.W., Strojek K., Kowalska I., Bozikov V., Gitt A.K., Jermendy G., Campaigne B.N., Kerr L., Milicevic Z., Jacober S.J. Effects of prandial versus fasting glycemia on cardiovascular outcomes in type 2 diabetes: the HEART2D trial. Diabetes Care. 2009;32: 381-86.
  17. Kilpatrick E.S., Rigby A.S., Atkin S.L. A1C Variability and the Risk of Microvascular Complications in Type 1 Diabetes: Data from the Diabetes Control and Complications Trial. Diabetes Care. 2008;31(11):2198-202.
  18. Brownlee M., Hirsch I.B. Glycemic variability: a hemoglobin A1cindependent risk factor for diabetic complications JAMA. 2006;295: 1707-78.
  19. Lachin J.M., Genuth S., Nathan D.M., Zinman B., Rutledge B.N.; DCCT/EDIC Research Group. Effect of glycemic exposure on the risk of micro-vascular complications in the diabetes control and complications trial revisited. Diabet. 2008;57: 995-1001.
  20. Waden J., Forsblom C., Thorn L.M., Gordin D., Saraheimo M., Groop P.H. A1C Variability Predicts Incident Cardiovascular Events, Microalbuminuria, and Overt Diabetic Nephropathy in Patients With Type 1 Diabetes. Diabetes. 2009;58(11):2649-55.
  21. Muggeo M., Zoppini G., Bonora E., Brun E., Bonadonna R.C., Moghetti P., Verlato G. Fasting plasma glucose variability predicts 10-year survival of type 2 diabetic patients: the Verona Diabetes Study. Diabetes Care. 2000; 23(1):45-50.
  22. Ji Eun Jun, Sang-Man Jin, Jongha Baek, Sewon Oh, Kyu Yeon Hur, Myung-Shik Lee, Moon-Kyu Lee, and Jae Hyeon Kim. The association between glycemic variability and diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes. Cardiovascular Diabetoly. 2015;14:70.
  23. Cavalot F. Do data in the literature indicate that glycaemic variability is a clinical problem? Glycaemic variability and vascular complications of diabetes. Diabetes Obes. Metab. 2013;15(Suppl. 2):3-8.
  24. Бабенко А.Ю. Красильникова Е.И. Лихоносов Н.П., Лихоносова А.П., Гринева Е.Н. Влияние различных групп сахароснижающих препаратов на вариабельность гликемии у больных сахарным диабетом 2 типа. Сахарный диабет. 2014;(4):72-80.
  25. Ceriello A., Kilpatrick E.S. Glycemic variabi lity: both sides of the story. Diabetes Care. 2013;36(Suppl. 2):272-75.
  26. Sourij H., Saely C.H., Schmid F., Zweiker R., Marte T., Wascher T.C., et al. Post-challenge hyperglycaemia is strongly associated with future macrovascular events and total mortality in angiographied coronary patients. European Heart J. 2010;31(13):1583-90.
  27. Su G., Mi S, Tao H., Li Z., Yang H., Zheng H., Zhou Y., Ma C. Association of glycemic variability and the presence and severity of coronary artery disease in patients with type 2 diabetes. Cardiovasc. Diabetol. 2011;10:1119-86.
  28. Zhang X., Xu X., Jiao X., Wu J., Zhou S., Lv X. The effects of glucose fluctuation on the severity of coronary artery disease in type 2 diabetes mellitus. J. Diabetes Res. 2013;2013:576916-3723244.
  29. Krinsley J.S. Glycemic variability: A strong independent predictor of mortality in critically ill patients. Critical Care Medicine. 2008;36(11):3008-13.
  30. Langouche L., Vanhorebeek I., Van den Berghe G. Therapy insight: the effect of tight glycemic control in acute illness. Nat. Clin. Pract. Endocrinol. Metab. 2007;3:270-78.
  31. Hsu C.R., Chen Y.T., Sheu W.H. Glycemic variability and diabetes retinopathy: a missing link. J. Diabetes Complications. 2015; 29:302-6.
  32. Jin S.M., Kim T.H., Oh S., Baek J., Joung J.Y., Park S.M., Cho Y.Y., Sohn S.Y., Hur K.Y., Lee M.S., Lee M.K., Kim J.H. Association between the extent of urinary albumin excretion and glycaemic variability indices measured by continuous glucose monitoring. Diabet. Med. 2015;32:274-79.
  33. Muggeo M., Verlato G., Bonora E., Zoppini G., Corbellini M., de Marco R. Long-term instability of fasting plasma glucose, a novel predictor of cardiovascular mortality in elderly patients with non-insulin-dependent diabetes mellitus: the Verona Diabetes Study. Circulation. 1997;96:1750-54.
  34. Zenari L., Marangoni A. What are the preferred strategies for control of glycaemicvariability in patients with type 2 diabetes mellitus? Diabetes, Obesity and Metabolism. 2013; 15(Suppl. 2):17-25.
  35. He Y.L., Foteinos G., Neelakantham S., Mattapalli D., Kulmatycki K., Forst T., et al. Differential effects of vildagliptin and glimepiride on glucose fluctuations in patients with type 2 diabetes mellitus assessed using continuous glucose monitoring. Diabetes Obes. Metab. 2013;15(12):1111-19.
  36. Marfella R., Barbieri M., Grella G., Rizzo M.R., Nicoletti G.F., Paolisso G. Effects of vildagliptin twice daily versus sitagliptin once daily on 24-hour acute glucose fluctuations. J. Diabet. Complicat. 2010;24:79-83.
  37. Neumiller J.J. Differential chemistry (structure), mechanism of action, and pharmacology of GLP-1 receptor agonists and DPP-4 inhibitors. J. Am. Pharm. Assoc. 2009;49(Suppl. 1):16-29.
  38. Rizzo M.R., Barbieri M., Marfella R., Paolisso G. Reduction of Oxidative Stress and Inflammation by Blunting Daily Acute Glucose Fluctuations in PatientsWith Type 2 Diabetes. Role of dipeptidyl peptidase-IV inhibition. Diabetes Care. 2012;35(10):2076-82.
  39. Xiaoyan C., et al. Poster 1230 presented at 75th ADA, June 5-9, 2015, Boston, MA, USA.

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