The first key historical study, with over 10 years of follow-up, showing that fasting glucose variability was an independent predictor of cardiovascular mortality, was published almost 20 years ago2. Considering data from clinical studies where treatment may be more intense than in real-life settings, the ADVANCE trial reported that the consistency of glycaemic control was important in order to reduce the risks of both macrovascular and microvascular events3. More recently, DEVOTE 2 showed that higher day-to-day fasting glycaemic variability was associated with increased risk of severe hypoglycaemia and all-cause mortality (Table)4. Lastly, the latest analysis of the VADT trial further documented that variability of fasting glucose plays a role in the development of cardiovascular complications, beyond the influence of standard fasting glucose measures; the adverse consequences of fasting glucose variability on cardiovascular disease appear to be highest in patients receiving intensive glucose control5. Considering these and other studies, the link between glucose variability and diabetic complications, and especially increased cardiovascular risk, is well documented.