Research or info about BGs

[runner]

Hi, does anyone know of any research or detailed info I can read about the impact of fluctuating blood sugars? I'm looking to find out if the emphasis should be on overall good levels of BG control, (I guess, as refelctd in a good HbA1c result) and/or the impact of short-term variations in ranges. For example, what the impact might be of BGs ranging from from 4.5 - 13 over a day, when average BG would be within range.

 

[Northerner]

There's a huge amount of information on Jenny Ruhl's website:

http://www.phlaunt.com/diabetes/14045678.php

 

[HelenM]

I've been trying to write a blog about this for ages, ie How important are day to day, hour to hour variations in glucose levels? Do wide fluctuations matter in the longterm?
The evidence is by no means all in the same direction. I started from Jenny Ruhls blog but when I looked further I soon found there wasn't a straightforward answer.
Two leading protagonists discussed variability at an ADA meeting in 2007 Louis Monnier who believes day to day (and within day) variablity is important in the development of complications. E Kilpatrick who has analysed the DCCT and Epic data and says that there is no evidence that intraday variability has An account of their discussion is here:
http://care.diabetesjournals.org/content/30/11/2965.full
There is a set of powerpoint slides by Kilpatrick... the ones towards the end are about variability
http://www.york.ac.uk/healthsciences/diabetes/2008conf/ekilpatrick.pdf
His most recent paper
Effect of Glucose Variability on the Long-Term Risk of Microvascular Complications in Type 1 Diabetes
http://care.diabetesjournals.org/content/32/10/1901.full?sid=a38fab9e-4ca4-4416-9a85-0b5a5993c0ab
and his previous papers are mostly available in full text.

Monnier
Glycemic Variability
Should we and can we prevent it

http://care.diabetesjournals.org/content/31/Supplement_2/S150.full?sid=89de471e-a2d4-4a06-bdf7-b491900560c3

Another recent research paper which suggests that variability is significant in
the development of neuropathy
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B8CX1-4TJ6009-1&_user=10&_coverDate=12%2F31%2F2008&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1283585089&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=53dbff5e441d3be6276993511e6fca91


After that with all the references in the papers you can research ad infinitum.... which is why I still haven't written that blog! and no conclusions either.

 

[Northerner]

Thanks for that information Helen. From what I can gather....erm...diabetes is never straightforward!😱🙄😉

There must be so many diabetics in the world that never know about any of this stuff, and never question if they are doing the right thing for their diabetes, and maybe accepting that it will 'get them' in one way or another eventually. I know, I've actually met such people. Is it better to not know and accept, or to seek out knowledge and agonise over deciding the best course of action? I'm afraid I'm the type that needs to know, as most people who use this forum are.

 

[runner]

Thanks for the links Helen and Alan. Yes, I need to know too, just so I can make some informed decisions really - for me it is about enjoying life and not being totally dominated by diabetes management, but avoiding complications for as long as possbile (or forever!).

I'll have a read anyway and see where it takes me. If I come across anything else, I'll let you know.

 

[sofaraway]

Very interesting subject and when I have more time then I'll have a read of those links.

One thing that I concentrate on for myself is that whether it matters or not having day to day flucuations, and the occasional highs etc. They don't make me feel well. Day to day I don't feel well having flucuations, so even if that has no effect on the long term it's still worth doing the work to avoid them.