Glucose variability (GV) has emerged as an important component of dysglycaemia.
GV is an independent risk factor for diabetic complications, macro- and micro-vascular. Both short- and long-term GV has also an important role in precipitating and accelerating hypoglycaemia and consequently adverse cardiovascular outcomes.
Currently several indices of GV are being proposed for its evaluation in clinical practice.
To assess short term, within-day GV, the coefficient of variation might be a simple and useful tool for separating stable from labile glycaemic control with a cut-off value of 36%. In contrast, longer-term GV can be defined based on quarterly visit-to-visit measurements of HbA1c, fasting or post-prandial glucose.
Meanwhile, a number of therapeutic strategies, both non-pharmacological (continuous glucose monitoring and life style changes) and pharmacological (GLP-1 receptor agonists, SGLT-2 inhibitors, new long acting insulins and also their fixed combinations with GLP-1 receptor agonists) are available to address this challenging aspect of diabetes management.