What should we expect from the regulation of glycemic variability?

Some aspects of glycemic variability are still not clear. Questions like the role that "short term glycemic variability" could play in the development of diabetic complications is still unanswered. On the other hand, A1C variability, or "long term glycemic variability", emerges as one of the most relevant actors in development and progression of the chronic vascular complications of diabetes. Furthermore, glycemic variability plays a central role in causing dangerous and unnoticed hypoglycemia, and it becomes the limiting factor to achieve an optimal regulation of diabetes. In this review, the most important aspects of glycemic variability are discussed, as well as clarifying, as far as is possible, what we should expect from its control. Some recommendations are also offered on how to evaluate it properly. (C) 2014 Sociedad Espanola de Diabetes. Published by Elsevier Espana, S.L. All rights reserved.