Glycemic variability and oxidative stress: A link between diabetes and cardiovascular disease?

Yoshifumi Saisho

Research output: Contribution to journalReview articlepeer-review

134 Citations (Scopus)


Diabetes is associated with a two to three-fold increase in risk of cardiovascular disease. However, intensive glucose-lowering therapy aiming at reducing HbA1c to a near-normal level failed to suppress cardiovascular events in recent randomized controlled trials. HbA1c reflects average glucose level rather than glycemic variability. In in vivo and in vitro studies, glycemic variability has been shown to be associated with greater reactive oxygen species production and vascular damage, compared to chronic hyperglycemia. These findings suggest that management of glycemic variability may reduce cardiovascular disease in patients with diabetes; however, clinical studies have shown conflicting results. This review summarizes the current knowledge on glycemic variability and oxidative stress, and discusses the clinical implications.

Original languageEnglish
Pages (from-to)18381-18406
Number of pages26
JournalInternational journal of molecular sciences
Issue number10
Publication statusPublished - 2014 Oct 13
Externally publishedYes


  • Cardiovascular disease
  • Diabetes
  • Glycemic variability
  • Hypoglycemia
  • Oxidative stress

ASJC Scopus subject areas

  • Catalysis
  • Molecular Biology
  • Spectroscopy
  • Computer Science Applications
  • Physical and Theoretical Chemistry
  • Organic Chemistry
  • Inorganic Chemistry


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