Understanding glycemic variability: Focus on diabetic kidney disease

Purpose of Review: Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease globally. Hyperglycemia, hypertension, and family history are the traditional risk factors for the initiation and progression of DKD. Glycemic variability (GV) has also been considered as a risk factor for diabetes complications. Studies have already shown that GV increases the risk of macrovascular complications. The purpose of this review is to study the association of GV with DKD. Journal articles related to this topic were reviewed to get the data for this article. Summary In the setting of DKD, a higher GV has been observed. However, evidence to suggest GV as a risk factor for the development and progression of DKD is not sufficient. The data seem to suggest that the link between GV and diabetic microvascular complications has remained a hypothetical one, yet to be proven or disproven by appropriate studies. Randomized controlled trials using continuous glucose monitoring data will clarify the impact of GV and its management in DKD.