What is the relationship between continuous glucose monitoring (CGM)-derived metrics of glycemic variability and diabetes-related complications?
Continuous Glucose Monitoring, studied in 20852 participants (J Clin Endocrinol Metab 2022, PMID 35094087) — glycemic variability and low time in range (TIR) were associated with all studied microvascular and macrovascular complications of diabetes. More longitudinal studies and trials are needed to confirm these associations, especially for type 1 diabetes, where data are limited.
Source: J Clin Endocrinol Metab 2022, PMID 35094087 ↗ · Research map · How Magellan grades evidence · evidence confidence: low
J Clin Endocrinol Metab · 2022 · PMID 35094087 · DOI 10.1210/clinem/dgac034
Continuous glucose monitoring metrics, especially Time in Range, are associated with diabetes complications and may offer better insights than HbA1c alone.
The question
What is the relationship between continuous glucose monitoring (CGM)-derived metrics of glycemic variability and diabetes-related complications?
What they tested
The study implicitly hypothesizes that CGM-derived metrics, beyond HbA1c, are associated with diabetes complications and can provide insight into short-term glucose fluctuations.
How they did it
A systematic review was conducted by searching PubMed and Embase databases from January 1, 2010, to August 22, 2020. The search terms included 'type 1 diabetes', 'type 2 diabetes', 'diabetes-related microvascular and macrovascular complications', and 'measures of glycaemic variability'. Studies not using CGM or involving non-diabetic, acutely unwell, pregnant participants, or those using insulin pumps were excluded. The final review included 34 publications out of 1636 identified records, encompassing 20852 participants (663 with T1D and 19909 with T2D).
What they found
Glycemic variability and low time in range (TIR) were associated with all studied microvascular and macrovascular complications of diabetes. Higher TIR was specifically linked to a reduced risk of albuminuria, retinopathy, cardiovascular disease mortality, all-cause mortality, and abnormal carotid intima-media thickness. Peripheral neuropathy was primarily associated with the standard deviation of blood glucose levels (SD) and mean amplitude of glycemic excursions (MAGE).
What it means
The evidence supports an association between diabetes complications and CGM-derived measures of intraday glycemic variability. Time in range (TIR) was the most consistent measure, suggesting its growing importance in clinical practice.
Limitations
More longitudinal studies and trials are needed to confirm these associations, especially for type 1 diabetes, where data are limited.
The paper at a glance
| Title | Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring |
|---|---|
| Journal | J Clin Endocrinol Metab |
| Year | 2022 |
| PMID | 35094087 ↗ |
| DOI | 10.1210/clinem/dgac034 ↗ |
| Topic | Metabolic health, glucose & body composition |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
This citation sits behind the evidence grade on the pages below. Grades are set from the research and are independent of affiliate commissions.
Continuous Glucose Monitoring (CGM)
In randomized trials and meta-analyses, continuous and flash glucose monitoring modestly lowers HbA1c (about 0.2–0.3 percentage points on average) and, more strikingly, cuts time spent in hypoglycemia—by 38% in type 1 diabetes and by roughly half in insulin-treated type 2 diabetes—compared with fingerstick testing;
The FreeStyle Libre is a factory-calibrated, intermittently scanned ("flash") continuous glucose…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the relationship between continuous glucose monitoring (CGM)-derived metrics of glycemic variability and diabetes-related complications? [Plain-English summary of J Clin Endocrinol Metab 2022, PMID 35094087, DOI 10.1210/clinem/dgac034]. Magellan Longevity. https://magellanlongevity.com/study/x12.html@misc{magellan_x12,
title = {What is the relationship between continuous glucose monitoring (CGM)-derived metrics of glycemic variability and diabetes-related complications?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/x12.html}},
note = {Plain-English summary of PubMed PMID 35094087; DOI 10.1210/clinem/dgac034; J Clin Endocrinol Metab 2022. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
}https://magellanlongevity.com/study/x12.htmlRelated studies in the Magellan library
- Continuous Glucose Monitoring and Physical ActivityInternational Journal of Environmental Research and Public Health · 2022 · PMID 36231598
- Sulforaphane reduces hepatic glucose production and improves glucose control in patients with…Sci Transl Med · 2017 · PMID 28615356
- Astaxanthin supplementation impact on insulin resistance, lipid profile, blood pressure, and…Phytother Res · 2023 · PMID 37874168
- Prebiotic Inulin Supplementation and Peripheral Insulin Sensitivity in adults at Elevated Risk…Nutrients · 2021 · PMID 34579112
- The Effect of Berberine Supplementation on Glycemic Control and Inflammatory Biomarkers in…Clin Ther · 2023 · PMID 38016844
- Effect of carnosine on lipid profile, fasting blood glucose, HbA1C and insulin resistanceComplement Ther Med · 2019 · PMID 31987255
All 22 Magellan summaries on metabolic health, glucose & body composition →
Prefer the interactive version? Open this summary in the Magellan app → · Browse all 314 study summaries →