3 Topic Commentaries

Glycemic variability may signal retinal changes

• 

  Akrit Sodhi, MD, PhD

  Ophthalmology (Retina)

  •

  Johns Hopkins University School of Medicine, Wilmer Eye Institute

  These studies help explain why patients with diabetes who are initially started on tight glucose control, the cornerstone of diabetic management, or those who have high glycemic variability (transient episodes of very low — followed by very high — serum glucose levels), experience worsening of their diabetic eye disease.

  Source
• 

  Estelle M. Everett, MD, MHS

  Endocrinology

  •

  David Geffen School of Medicine at UCLA; VA Greater Los Angeles Healthcare System

  Glycemic variability is a known risk factor associated with diabetes complications, including retinopathy.

  Source
• 

  Andrew J. Barkmeier, MD

  Ophthalmology (Retina)

  •

  Mayo Clinic College of Medicine and Science, Department of Ophthalmology

  Regular hemoglobin A_{1 c} measurement is a cornerstone of diabetes management, but its accuracy may be impacted by other comorbid conditions, including kidney disease, and it does not capture key aspects of glycemic control, including variability, time in range, or episodic hypoglycemia.

  Source