Minimizing Glycemic Fluctuations in Patients With Type 2 Diabetes: Approaches and Importance

August 3, 2017. This review article examines the importance of and strategies for minimizing glycemic fluctuations in patients with type 2 diabetes (T2D). The authors note that measurements like A1C, fructosamine, and glycated albumin reflect a long-term average of plasma glucose and do not accurately measure short-term glycemic oscillations. Continuous glucose monitoring (CGM) more accurately monitors real-time glucose fluctuations. Additionally, certain T2D medications (dipeptidyl peptidase-4 inhibitors, sodium–glucose cotransporter 2 inhibitors, and glucagon-like peptide-1 receptor agonists) exert significant improvement on measures such as the mean amplitude of glucose excursions and standard deviation of CGM. According to the authors, available evidence suggests that glycemic fluctuations are a target that should be considered when managing T2D. This review article is available as a free download from this link.