Table 3.

Potential beneficial measures for addressing GV

Subjects	Measures	Results	References
Patients with type 1 diabetes	CGM	Reduced GV and improved protection against hypoglycemia	[87–89]
	Insulin analogues degludec	Minimized morning GV	[91]
	Canagliflozin	Improved indices of GV	[92]
	Dapagliflozin over 24 weeks	Improved GV without increasing the time spent in the range indicating hypoglycemia	[93]
	Empagliflozin as adjunct to insulin	Decreased glucose exposure and variability and increased time in glucose target range	[103]
	Combination of basal insulin with ipragliflozin or dapagliflozin	Improved TIR and the mean glucose level	[104]
	Low carbohydrate diet	Resulted in more time in euglycemia, less time in hypoglycemia	[108–110]
Patients with type 2 diabetes	Dapagliflozin on 24-h	Improved measures of GV	[94]
	Once-weekly trelagliptin and once-daily alogliptin	Improved glycemic control and reduced GV without inducing hypoglycemia	[95]
	Combination of basal insulin with a GLP-1 RA	Lowered GV and hypoglycemia	[96]
	Exenatide once weekly	Improved daily glucose control and reduced GV	[97]
	Lixisenatide added to basal insulin	Reduced GV and PPG excursions without increasing the risk of hypoglycemia	[98]
	Liraglutide	Lower mean time in hyperglycemia	[99]
	Combination of metformin and gemigliptin or sitagliptin	Significantly reduced GV	[100]
	Vildagliptin or pioglitazone	Significantly reduced MAGE, glycated hemoglobin and mean plasma glucose levels	[101]
	Combination of metformin and vildagliptin or glimepiride	Improved glucose level with a significantly greater reduction in GV and hypoglycemia	[102]
	Intensive insulin therapy combined with metformin	Reduced both glucose fluctuation and nocturnal hypoglycemic risk	[105]
	Low-carbohydrate high-fat diet	Reduced glycemic fluctuation	[106, 107, 111]
	Sequence of food ingestion	Associated with lower post-lunch glucose excursions and lower glucose coefficients of variation	[115]
	Aerobic and combined exercise sessions	Reduced glucose levels and GV	[116–118]
	Short-term exercise training	Improved glycemic control and GV but unaffected oxidative stress	[119, 121]
	Frequent interruptions of prolonged sitting	Improved fasting glucose and night-time glycemic variability	[120]
Others	Low glycemic index foods	Reduced the glycemic response and variability and promoted fat oxidation.	[112, 113]
	Food order	Reduced glycemic excursions	[114]
	Exercise in the fasted and postprandial state	Exercise in the postprandial state after breakfast, but not in the fasted state, decreased glucose excursions	[122]
	Aerobic and eccentric exercise	Reduced all the indices of GV	[123]
	Immediate post-breakfast physical activity	Improved mean, CV and AUC glucose	[124]

GV, glycemic variability; CGM, continuous glucose monitoring; CV, coefficient of variation; GLP-1 RA, glucagon-like peptide 1 receptor agonist; PPG, postprandial glucose; MAGE, mean amplitude of glycemic excursions; TIR, time in range; AUC, area under the curve