{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:53:08Z","timestamp":1793321588166,"version":"4.5.0"},"reference-count":85,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2022,1,30]],"date-time":"2022-01-30T00:00:00Z","timestamp":1643500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1136735"],"award-info":[{"award-number":["APP1136735"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1182464"],"award-info":[{"award-number":["APP1182464"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Although glycated hemoglobin A1c is currently the best parameter used clinically to assess risk for the development of diabetes complications, it does not provide insight into short-term fluctuations in glucose levels. This review summarizes the relationship between continuous glucose monitoring (CGM)-derived metrics of glycemic variability and diabetes-related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Acquisition<\/jats:title>\n                    <jats:p>PubMed and Embase databases were searched from January 1, 2010 to August 22, 2020, using the terms type 1 diabetes, type 2 diabetes, diabetes-related microvascular and macrovascular complications, and measures of glycaemic variability. Exclusion criteria were studies that did not use CGM and studies involving participants who were not diabetic, acutely unwell (post stroke, post surgery), pregnant, or using insulin pumps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Synthesis<\/jats:title>\n                    <jats:p>A total of 1636 records were identified, and 1602 were excluded, leaving 34 publications in the final review. Of the 20\u2005852 total participants, 663 had type 1 diabetes (T1D) and 19\u2005909 had type 2 diabetes (T2D). Glycemic variability and low time in range (TIR) showed associations with all studied microvascular and macrovascular complications of diabetes. Notably, higher TIR was associated with reduced risk of albuminuria, retinopathy, cardiovascular disease mortality, all-cause mortality, and abnormal carotid intima-media thickness. Peripheral neuropathy was predominantly associated with standard deviation of blood glucose levels (SD) and mean amplitude of glycemic excursions (MAGE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The evidence supports the association between diabetes complications and CGM-derived measures of intraday glycemic variability. TIR emerged as the most consistent measure, supporting its emerging role in clinical practice. More longitudinal studies and trials are required to confirm these associations, particularly for T1D, for which there are limited data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgac034","type":"journal-article","created":{"date-parts":[[2022,1,30]],"date-time":"2022-01-30T12:01:15Z","timestamp":1643544075000},"page":"e2221-e2236","source":"Crossref","is-referenced-by-count":264,"title":["Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4420-5350","authenticated-orcid":false,"given":"Michael","family":"Yapanis","sequence":"first","affiliation":[{"name":"Department of Medicine, the University of Melbourne, Parkville 3052, Victoria, Australia"},{"name":"Department of Endocrinology, Austin Health, Heidelberg 3084, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3928-9206","authenticated-orcid":false,"given":"Steven","family":"James","sequence":"additional","affiliation":[{"name":"School of Nursing, Midwifery and Paramedicine, the University of the Sunshine Coast, Petrie 4052, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6004-576X","authenticated-orcid":false,"given":"Maria E","family":"Craig","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, UNSW 2052, NSW, Australia"},{"name":"The University of Sydney Children\u2019s Hospital Westmead Clinical School, Westmead 2145, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0870-4032","authenticated-orcid":false,"given":"David","family":"O\u2019Neal","sequence":"additional","affiliation":[{"name":"Department of Medicine, the University of Melbourne, Parkville 3052, Victoria, Australia"},{"name":"Department of Endocrinology, St Vincent\u2019s Hospital, Fitzroy 3065, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2372-395X","authenticated-orcid":false,"given":"Elif I","family":"Ekinci","sequence":"additional","affiliation":[{"name":"Department of Medicine, the University of Melbourne, Parkville 3052, Victoria, Australia"},{"name":"Department of Endocrinology, Austin Health, Heidelberg 3084, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2022,1,30]]},"reference":[{"issue":"11","key":"2022051722412919200_CIT0001","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.2522\/ptj.20080020","article-title":"Epidemiology of diabetes and diabetes-related complications","volume":"88","author":"Deshpande","year":"2008","journal-title":"Phys Ther."},{"key":"2022051722412919200_CIT0002","volume-title":"National Diabetes Statistics Report, 2020.","author":"US Department of Health and Human Services. 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