Introduction and Objective: Discrepancy between HbA1c and glucose management index (GMI) is usual but its stability over time is unknown.Methods: We analyzed 386 patients with diabetes (83% type 1) in 10 centers. They had continuous glucose monitoring (CGM) with FreeStyleLibre® 1 or 2 (FSL). For each participant, we specifically collected CGM data over 90 days and concomitant HbA1c level at Month 0 (M0), 12 (M12) and 24 (M24). We calculated the HbA1c/GMI ratio and considered three groups: ratio≤0.95 (G-), 0.96-1.05 (G=) and >1.05 (G+).Results: At M0, mean age was 51±17 years, HbA1c 7.6±1.0%, GMI 7.4±0.8%. The mean HbA1c/GMI ratio changed over time (1.031 at M0, 1.015 at M12 and 0.999 at M24; p<0.05 even after adjustment for FSL type). At M0, the repartition in G-, G= and G+ was 12.2%, 44.0% and 43.8%, respectively (X-axis). Many individuals switched to other groups at M12 (Y-axis) and further at M24 (G- in green, G= in orange and G+ in red). The 13.2% of patients consistently G+ at M0-M12-M24 were associated to high age (by 10 years: aOR 1.45 (95%CI 1.15-1.84, p=0.002), but not complications.Conclusion: The high instability of the HbA1c/GMI ratio over time can be explained by time-varying unmeasured individual and collective factors and measurement errors, suggesting that both indicators should be considered per se during follow-up of patients.
E. Cosson: Board Member; Abbott Diagnostics, Amgen Inc, Bayer Pharmaceuticals, Inc, Boehringer-Ingelheim, Dexcom, Inc., Lilly Diabetes, Medtronic, Novartis AG, Novo Nordisk, Roche Diagnostics, Sanofi. G. Prevost: None. P. Oriot: Research Support; Abbott. A. Andrieu: None. A. Vandelaer: None. M. Joubert: Board Member; Abbott, Medtronic, Insulet Corporation, Dexcom, Inc., Ypsomed AG, Lilly Diabetes, Novo Nordisk, Sanofi. R. Leroy: Consultant; Elivie -home health provider. Research Support; Medtronic, MEDTRUM. P.A. Monguillon: Consultant; Abbott Diagnostics, Novo Nordisk, Sanofi, Eli Lilly and Company, AstraZeneca. A. Penfornis: Speaker’s Bureau; Abbott, AstraZeneca. Board Member; Abbott. Speaker’s Bureau; Boehringer-Ingelheim, Dexcom, Inc., Eli Lilly and Company. Board Member; Insulet Corporation. Speaker’s Bureau; Insulet Corporation. Board Member; Medtronic. Speaker’s Bureau; Menarini. J. Philips: None. J. Julla: Other Relationship; Lilly Diabetes. Board Member; Sanofi. Other Relationship; Novo Nordisk. A. Gillibert: None. M. Vannier: None. J. Riveline: Consultant; Abbott, Lilly Diabetes, Novo Nordisk, Sanofi, Dexcom, Inc., Air Liquide, Insulet Corporation. Research Support; Tandem Diabetes Care, Inc, Juvenile Diabetes Research Foundation (JDRF).
Source link
Leave a Reply