A.CHAN1, S.LOW1, J. KHOO1, J.G.TAN1, B.LAM1, E.YEOH1, S.C.LIM1
Khoo Teck Puat Hospital1
Glycemic variability contributes to oxidative stress, endothelial dysfunction and diabetic complications. It also confers higher risk of incident type 2 diabetes. There is ample research on measuring glycemic variability in patients with diabetes. However, there is sparse data on normative range for non-diabetic individuals which are essential for treatment targets and clinical research.
Ninety-five participants with normoglycemia (fasting plasma glucose < 6.0 mmol/l) underwent flash glucose monitoring using Freestyle Libre (Abbott Diabetes Care Inc., Alameda, CA, USA) for up to 14 days in a cross-sectional study. EasyGV© software was used to calculate glycemic variability, yielding Standard Deviation (SD), Continuous Overlapping Net Glycemic Action (CONGA), Lability Index (LI), J-Index, Low Blood Glucose Index (LBGI), High Blood Glucose Index (HBGI), Glycemic Risk Assessment in Diabetes Equation (GRADE), Mean of Daily Differences (MODD), Mean Amplitude of Glycemic Excursions (MAGE), Average Daily Risk Ratio (ADRR), M-value and Mean Absolute Glucose (MAG). The normative range were calculated as geometric mean ± 2SD.
The participants’ mean age was 34.9 ± 10.0 years. The mean glucose level was 4.7 ± 0.6 mmol/l. The normative reference ranges for glycemic variability were calculated: SD, 0.0-3.6; CONGA, 1.8-6,4; LI, 0.0-4.5; J-Index, 8.1-13.3; LBGI, 1.8-8.8; HBGI, 0.0-5.0; GRADE, 0.0-5.8; MODD, 0.0-3.5; MAGE, 0.1-5.3; ADDR, 0.0-8.0; M-value 4.1-12.5; and MAG, 0.0-3.6. There is no significant difference in these indices by gender and body mass index.
Normative ranges calculated from the cross-sectional study serve as a guide for measures of glycemic variability in non-diabetic adults for use in clinical care and academic assessment.