ReviewDiabetology & metabolic syndrome2025
The prognostic role of glycemic variability in predicting the risk of adverse cardiovascular events in patients with cardiovascular diseases: a meta-analysis.
Review in Diabetology & metabolic syndrome, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictive value of different glycemic variability indicators for prognosis in critically ill patients: a meta-analysis.Frontiers in endocrinology · 2026Pooled it
- [Effect of glycemic variability on the efficacy of artificial pancreas systems: A real-world study].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026Article
- HbA1c as a Continuous Marker of Microvascular Vulnerability: Development of a Non-Linear Risk Framework in a Real-World Cohort.Metabolites · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlycemic variability (GV) reflects glucose fluctuations, and increased GV is associated with adverse cardiovascular outcomes. We systematically evaluated the association between GV, measured by the mean amplitude of glycemic excursions (MAGE) and standard deviation (SD), and cardiovascular risk in patients with pre-existing cardiovascular disease (CVD). MATERIALS AND
methodsWe searched PubMed, Embase, Scopus, Web of Science, and CENTRAL through May 2025 for studies on GV and cardiovascular outcomes in patients with established cardiovascular disease. Random-effects models with Knapp-Hartung adjustment were used to pool the risk ratios (RRs) and 95% confidence intervals (CIs). Subgroup, sensitivity, and meta-regression analyses were used to explore heterogeneity. The risk of bias was assessed using the ROBINS-I tool.
resultsSeventeen studies comprising 6,096 patients were included. In the categorical analysis, higher MAGE (RR: 2.18; 95% CI: 1.70, 2.80; I² = 15.6%) and SD (RR: 1.94; 95% CI: 1.32, 2.87; I² = 55.9%) were associated with increased risk of major adverse cardiovascular events (MACE). Continuous MAGE was also associated with MACE (RR: 1.66; 95% CI: 1.28, 2.14; I² = 65.65%), while continuous SD showed a non-significant association. The adjusted analyses for MAGE reinforced these findings. The MAGE cut-off thresholds significantly moderated the effect sizes in the meta-regression analysis. Subgroup analyses showed between-group differences in SD according to diabetes status and in MAGE according to country and follow-up duration. The certainty of evidence (GRADE) was very low for all contrasts. In outcome-specific analyses, both MAGE and SD were associated with acute heart failure and myocardial infarction, but not cardiovascular mortality.
conclusionGV, particularly when assessed using MAGE, is a significant predictor of cardiovascular risk in patients with pre-existing CVD. While these findings support its prognostic utility, limitations such as the observational design and residual confounding warrant cautious interpretation. Further studies should establish standardized thresholds and dose-response relationships. REGISTRATION: PROSPERO CRD420251002622.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.