Impacts of glycemic variability on the relationship between glucose management indicator from iPro™2 and laboratory hemoglobin A1c in adult patients with type 1 diabetes mellitus. (June 2020)

• Record Type: Journal Article
• Authors: Liu, Hongxia; Yang, Daizhi; Deng, Hongrong; Xu, Wen; Lv, Jing; Zhou, Yongwen; Luo, Sihui; Zheng, Xueying; Liang, Hua; Yao, Bin; Qiu, Liling; Wang, Funeng; Liu, Fang; Yan, Jinhua; Weng, Jianping
• Is Part Of: Therapeutic advances in endocrinology and metabolism. Volume 11(2020)
• Publication Date: 2020-06
• Subjects: glucose management indicator -- glycated hemoglobin A1c -- glycemic variability -- diabetes mellitus -- type 1; Endocrine glands -- Diseases -- Treatment -- Periodicals; Metabolism -- Disorders -- Treatment -- Periodicals; Endocrine System Diseases -- therapy -- Periodicals; Metabolic Diseases -- therapy -- Periodicals; 616.4005
• DOI: 10.1177/2042018820931664
• Languages: English
• ISSNs: 2042-0188

Abstract

Aims: Our aim was to investigate the impact of glycemic variability (GV) on the relationship between glucose management indicator (GMI) and laboratory glycated hemoglobin A1c (HbA1c). Methods: Adult patients with type 1 diabetes mellitus (T1D) were enrolled from five hospitals in China. All subjects wore the iPro ™ 2 system for 14 days before HbA1c was measured at baseline, 3 months and 6 months. Data derived from iPro ™ 2 sensor was used to calculate GMI and GV parameters [standard deviation (SD), glucose coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE)]. Differences between GMI and laboratory HbA1c were assessed by the absolute value of the hemoglobin glycation index (HGI). Results: A total of 91 sensor data and corresponding laboratory HbA1c, as well as demographic and clinical characteristics were analyzed. GMI and HbA1c were 7.20 ± 0.67% and 7.52 ± 0.73%, respectively. The percentage of subjects with absolute HGI 0 to lower than 0.1% was 21%. GMI was significantly associated with laboratory HbA1c after basic adjustment (standardized β = 0.83, p < 0.001). Further adjustment for SD or MAGE reduced the standardized β for laboratory HbA1c from 0.83 to 0.71 and 0.73, respectively (both p < 0.001). In contrast, the β remained relatively constant when further adjusting for CV. Spearman correlation analysis showed that GMI and laboratory HbA1c were correlated for each quartile of SD and MAGE (all p < 0.05), with the corresponding correlation coefficients decreased across ascending quartiles. Conclusions: This study validated the GMI formula using the iPro ™ 2 sensor in adult patients with T1D. GV influenced the relationship between GMI and laboratory HbA1c.