1. Seley, Jane Jeffrie MPH, MSN, GNP, BC-ADM, CDE


A report from Greece.


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In February I joined health care professionals in Athens for the 2nd International Conference on Advanced Technologies and Treatments for Diabetes.

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One of the hottest debates was whether to focus on hemoglobin AIc values or glucose variability when evaluating glycemic control (see this month's Diabetes Under Control). The hemoglobin AIc assay measures glycemic control over a two-to-three-month period. There's a high correlation between a reduction in the hemoglobin AIc value and a decrease in long-term complications of diabetes.


Glucose variability refers to the "swings" in blood glucose levels that one has in a given day. Irl Hirsch, an endocrinologist from Seattle, suggested that high glucose variability may be an independent risk factor for microvascular complications and more detrimental in people with diabetes than chronic hyperglycemia. Boris Kovatchev, of the University of Virginia, discussed the assessment and clinical relevance of glucose variability. He uses data on continuous glucose monitoring along with daily blood glucose monitoring to identify glucose fluctuations and stratify the risk of developing diabetes complications over time. As more insurance companies reimburse patients for continuous monitoring supplies, many patients and providers will be able to examine round-the-clock glucose trends and stop basing clinical decisions on the limited information obtained from glucose meters. Pictured here is Neesha Ramchandani, PNP (right), presenting a poster to a participant at the conference.


Jane Jeffrie Seley, MPH, MSN, GNP, BC-ADM, CDE