Association of various glycemic variability indices and vascular outcomes in type-2 diabetes patients: A retrospective study

Both blood glucose (BG) level and glycemic variability (GV) significantly associate with diabetes-related complications. However, the criterion standard in GV assessment is absent. We aimed to compare different GV indices in association of vascular outcomes. Ten commonly used GV indices based on self-monitored BG data were calculated, and their associations of vascular outcomes including coronary artery disease (CAD), stroke, and chronic kidney disease (CKD) were compared. In total, 288 type 2 diabetes patients (66.5 ± 11.1 years old) were included in present analysis. Spearman correlation analysis showed that only mean amplitude of glycemic excursions (MAGE) significantly correlated with both estimated glomerular filtration rate and urinary albumin creatinine ratio (P ≤ .03). In Cochran-Armitage trend test, vascular outcomes were significantly associated with the increment of BG risk index and MAGE (P ≤ .03). After adjustment for potential confounders, multiple logistic regression results suggested that BG risk index and MAGE still significantly associated with these three vascular outcomes (P ≤ .01), whereas the other GV indices did not. Receiver operating characteristic curve analysis showed that the abilities of BG risk index and MAGE were similar in identifying CAD, stroke, or CKD. BG risk index and MAGE were better associated with vascular outcomes than other GV indices in type 2 diabetes patients.