Relationship of A1C to Glucose Concentrations in Children With Type 1 Diabetes
Year: 2008
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Despite the standing of A1C as the most validated and widely used measure for average glycemic control over time, the relationship between A1C and glucose concentrations is not completely understood. The purpose of this Diabetes Research in Children Network (DirecNet) study was to use continuous glucose monitoring data to examine the relationship between A1C and glucose in type 1 diabetes. RESEARCH DESIGN AND METHODS: Forty-eight youth enrolled in studies of the Navigator continuous glucose monitor were encouraged to wear the Navigator sensor at home continuously. A1C was measured at baseline, at 3 months, and at 6 months. Sensor glucose data were directly transmitted via the Internet, assuring that essentially all glucose values were analyzed. RESULTS: Subjects had a median of 112 h/week of Navigator data in the first 3 months and 115 h/week in the second 3 months. The slope of mean glucose over the previous 3 months versus A1C was only 18 mg/dl per 1.0% A1C. Individually, there was substantial variation in the relationship between mean glucose and A1C. A1C was not associated with glucose lability after controlling for mean glucose. Measures of an individual's rate of glycation were moderately correlated at the 3- and 6-month visits. CONCLUSIONS: As the chemistry of glycation would predict, we found no evidence to contradict the simple hypothesis that A1C directly reflects mean glucose over time. There is, however, substantial variability in individual mean glucose concentrations for a given A1C. Transforming reliable A1C values into calculated mean glucose values would, when applied to an individual, introduce substantial error.
Source: Diabetes Care
DOI: 10.2337/dc07-1835
Author: Diabetes Research in Children Network (DirecNet) Study Group
Institution: Jaeb Center for Health Research
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Glucose Sensors in Children with Type I Diabetes, Coordinating Center for Studies of Glucose Sensors in T*, GENERAL CLINICAL RESEARCH CENTER, General Clinical Research Center, Prevention of Nocturnal Hypoglycemia: Effect on Neurologic Outcome in Toddlers, G2678868255, G3523927888, Hypoglycemia in Children and Adolescents with T1DM: Mechanisms and Prevention, General Clinical Research Center, Cooperative Multicenter Diabetes Research Network for Hypoglycemia Prevention, Prevention of Hypoglycemia and Associated Complications in Type 1 Diabetes, General Clinical Research Center, Yale Study of Closed-Loop Automated Glucose Control for Hypoglycemia Prevention
OpenAlex ID: W1674375000