Glucose or glycemic variability is when the glucose levels in the blood have spiked. They either go abnormally higher (hyperglycemia) or fall below normal (hypoglycemia). This oscillation of glucose levels in the blood goes on throughout the day. The hypoglycemic state and postprandial increase occur simultaneously. A person can have glucose variability experiences fluctuations in glucose levels in the blood at the same time on different days.
Under normal circumstances, your body will have some fluctuations in sugar levels in your bloodstream. Intake of food, sleeping habits and mood you are in contributes to the level of glucose in your blood. This is a normal situation while your body is processing glucose.
Though fluctuations in sugar levels in the blood may be a natural phenomenon, the quantum of glucose variability is an area of concern. Wide and sharp variability between very high and extremely low blood sugar levels is not a situation you would like to find yourself in. These sharp spikes in glucose levels in the blood have ramifications on your health. You need to aim at having a situation where the variability is low.
Various methods are used to quantify postprandial glycemia or glucose variability, but few have been compared and none are standardized. Our objective was to examine the relationship among common indexes of postprandial glycemia, overall hyperglycemia, glucose variability, and A1C using detailed glucose measures obtained during everyday life and to study which blood glucose values of the day provide the strongest prediction of A1C.
Currently, glycated haemoglobin (HbA1c) is the most popular way to assess glycemic variability and responsiveness to the treatment done on patients having either Type I or Type II diabetes mellitus. HbA1c has proven to be an essential indicator of glucose variability for the past three decades. A good result in the HbA1c test has proven to be a boon against complications of the eyes, kidneys etc. Reduction in HbA1c also helps reduce cardiovascular risks, which is a common diabetes-related complication. Various studies have proven that an HbA1c reading of 6.5 per cent to 7.5 per cent in patients suffering from diabetes is ideal. The treatment plans are set around this goal to mitigate risks like hypoglycemia and other related complications.
As discussed above, glucose variability is a situation where a person experiences sudden surges in blood sugar levels and faces hypoglycemia, i.e. sudden fall in the blood sugar levels.
These spikes, whether it is a case of sugar level in the blood going up or down, cause other health hazards over some time. Frequent glucose variability very often results in insulin resistance in the body. The zenith and nadir in sugar levels in the blood may damage tissues than a situation where the blood sugar level is high yet stable. Heart diseases, dysfunction of the body metabolism and uncontrolled diabetes may be linked with glucose variability.
A person experiencing frequent and high degrees of glucose variability may also be heading for a disruption in the metabolic health of that person. Under this situation, the body becomes resistant to insulin, i.e. the body becomes incapable of using insulin to break glucose content in the blood effectively to control glucose and generate energy.
While the main aim of treating a person having diabetes is to keep the sugar levels in the bloodstream under control, hypoglycemia, where there is an abnormal drop in the blood sugar level, is a complicated situation. Hypoglycemia in a diabetic person may lead to coma or even death.
Various studies have shown that a person showing tendencies of frequent and high degrees of glucose variability has gone into complications arising out of hypoglycemia. At the same time, a person who has not experienced glucose variability has shown less inclination towards an abnormal drop in blood sugar levels.
In short, the answer to the question above is yes. Glucose variability needs immediate and expert intervention. Experts think that glucose variability needs to be considered under a specific treatment plan for critically ill non-diabetic patients. For a person undergoing treatment in an intensive care unit, the sugar level in the blood needs to be kept under a controlled parameter. Frequent and sharp drops in blood sugar may prove fatal. Glucose regulation by keeping glucose variability under control for critically ill patients is critical.
For a patient who already has diabetes and is taking insulin treatment, controlling glucose variability is more complicated. Insulin doses cannot be stopped for a diabetic, and at the same time, the threat of hypoglycemia goes up if the person happens to experience glucose variability.
Patients who are already diabetic and are suffering from glucose variability may be treated with long-acting insulin analogues like Insulin Detemir or Insulin Glargine. Studies have shown that long-acting insulin analogues have reduced the chances of hypoglycemia and glucose variability in a patient. It has also been noticed that a patient suffering from recurrent bouts of glucose variability benefits from continuous subcutaneous (sc) insulin doses. The same helps in maintaining stability in the blood sugar levels.
The glucose variability is measured by glucose excursions, the difference between the maximum and minimum blood sugar levels in a body. For a person who is not a diabetic and is not obese, the glucose excursion should remain between 26-28 mg/dL. The doctors advise not to exceed the limit of more than 30 mg/dL from your pre-meal levels.
The best way to avoid glucose variability is to maintain a stable blood sugar level even if you are a diabetic. That would mean consuming low carb, high fibre food and exercise and healthy sleep.