The potential effect of ultra-long insulin degludec on glycemic variability

[Diagnosis and insulin therapy of type 1 diabetes mellitus (Update 2023)]

This guideline summarizes diagnosis of type 1 diabetes, including accompanying autoimmune disorders, insulin therapy regimens and glycemic target values.

[Injection therapy of diabetes]

The present article is a recommendation of the Austrian Diabetes Association for the practical use of injection therapy (GLP1-receptor agonists and insulin) in type 2 diabetes.

Perspectives of glycemic variability in diabetic neuropathy: a comprehensive review

Diabetic neuropathy is one of the most prevalent chronic complications of diabetes, and up to half of diabetic patients will develop diabetic neuropathy during their disease course. Notably, emerging evidence suggests that glycemic variability is associated with the pathogenesis of diabetic complications and has emerged as a possible independent risk factor for diabetic neuropathy. In this review, we describe the commonly used metrics for evaluating glycemic variability in clinical practice and summarize the role and related mechanisms of glycemic variability in diabetic neuropathy, including cardiovascular autonomic neuropathy, diabetic peripheral neuropathy and cognitive impairment. In addition, we also address the potential pharmacological and non-pharmacological treatment methods for diabetic neuropathy, aiming to provide ideas for the treatment of diabetic neuropathy.

Zhang et al. describe metrics for evaluating glycaemic variability (GV) in clinical practice and summarize the role and related mechanisms of GV in diabetic neuropathy, including cardiovascular autonomic neuropathy, diabetic peripheral neuropathy and cognitive impairment. They aim to stimulate ideas for the treatment of diabetic neuropathy.

[Insulin therapy of type 2 diabetes mellitus (Update 2019)]

The present article is a recommendation of the Austrian Diabetes Association for the practical use of insulin in type 2 diabetes, including the various insulin regimens.

[Diagnosis and insulin therapy of type 1 diabetes mellitus (Update 2019)]

This guideline summarizes diagnosis of type 1 diabetes, including accompanying autoimmune disorders, insulin therapy regimens and glycemic target values.

Does sucrose affect the glucose variability in patients with type 1 diabetes? a pilot crossover clinical study

OBJECTIVE

The aim of this study was to compare the effects of a sucrose-free diet with a sucrose-added diet on glucose variability in patients with type 1 diabetes.

METHODS

This was a two-way crossover design study in which patients with type 1 diabetes were monitored by blinded continuous glucose monitoring and were selected to receive a sucrose-free diet (<30 g/d), followed by a sucrose-added diet (>80 g/d) for 2 d each. Intra-day glucose variability was assessed by the mean amplitude of glycemic excursions (MAGE), the M-value, J-index, glycemic risk assessment in diabetes equation (GRADE), and continuous overlapping net glycemic action (CONGA_1-3). Between-day variability was determined by mean of daily difference (MODD). Statistical analyses were performed with a significance level of 5%.

RESULTS

Ten patients with type 1 diabetes were evaluated. The participants were a mean of 26.1 ± 7.1 y of age. The mean duration of disease was 16.5 ± 10.5 y, and patients' mean glycated hemoglobin was 7.4% ± 0.8%. The intra- and inter-day glucose variability indexes did not differ between the diet periods (MAGE: 10.2 ± 5.1 and 10.4 ± 6.8mmol/L, P = 0.98; M-value: 12.9 ± 2 and 15.6 ± 1.3mmol/L, P = 0.29; J-index: 50.9 ± 4.4 and 57.7 ± 3.3mmol/L, P = 0.41; GRADE: 7.2 ± 1 and 4.7 ± 5.3mmol/L, P = 0.07; and MODD: 3.9 ± 1 and 4.3 ± 1.5mmol/L, P = 0.28; for the sucrose-free and sucrose-added diets, respectively). CONGA_1-3 were similar for both diet periods (P > 0.05).

CONCLUSIONS

The use of a moderate amount of sucrose, as part of a balanced diet, did not affect the glucose variability or insulin requirements in patients with type 1 diabetes.