Table 2

Association of measures of glucose variability over a mean of 6.5 years of quarterly follow-up in the DCCT with progression of complications

Adjusted for mean blood glucose*
Hazard ratio95% CLZ valueP value
Retinopathy
 Within-day
  SD0.9370.834, 1.054−1.080.28
  MAGE0.9380.837, 1.050−1.110.27
  M-value0.8040.582, 1.112−1.320.19
 Longitudinal
  Total blood glucose variance0.9510.844, 1.072−0.830.41
  Between-day variance0.9200.839, 1.009−1.760.08
  Within-day variance0.9700.872, 1.080−0.550.59
  Mean MAGE0.9660.853, 1.095−0.540.60
  Mean M-value0.9720.792, 1.191−0.280.79
Microalbuminuria
 Within-day
  SD1.0210.842, 1.2380.210.84
  MAGE1.010.834, 1.2130.0620.96
  M-value0.8990.517, 1.564−0.380.71
 Longitudinal
  Total blood glucose variance1.0840.838, 1.4010.610.54
  Between-day variance1.1320.999, 1.2831.950.06
  Within-day variance0.9040.698, 1.172−0.760.45
  Mean MAGE0.8120.621, 1.062−1.520.13
  Mean M-value2.1421.505, 3.0484.23<0.0001
Odds ratio
Cardiovascular autonomic neuropathy
 Within-day
  SD1.0980.952, 1.2681.290.20
  MAGE1.1380.999, 1.2981.930.06
  M-value1.3360.953, 1.8741.680.10
 Longitudinal
  Total blood glucose variance1.3571.114, 1.6553.030.0025
  Between-day variance1.2211.052, 1.4162.630.0087
  Within-day variance1.1320.946, 1.3551.350.18
  Mean MAGE1.1550.925, 1.4441.270.21
  Mean M-value1.0110.690, 1.4830.060.96
  • *Models for the association of within-day measures of variation with the risk of progression of microvascular complications are also adjusted for the within-day mean blood glucose; models for longitudinal measures of variation are adjusted for the longitudinal mean level of blood glucose. The hazard ratio is from a Cox proportional hazards model of the incidence of retinopathy and nephropathy progression over time, and the odds ratio is from a general estimating equation logistic regression model of prevalence of CAN at 2, 4, 6, and 8 years of follow-up.

  • The association of all measures with progression of complications without adjustment for the mean blood glucose is shown in the Supplementary Data. CL, confidence limits.

  • †After applying the Holm procedure to correct for the total of 24 tests, only the effect of the mean M-value on risk of microalbuminuria (Z = 4.23) meets the criteria for significance at the 0.05 level.