Year: 2019
Type: article
Abstract: Aims To identify clinically useful associations between HbA1c levels and various continuous glucose monitoring‐derived metrics. Methods We retrospectively analysed end‐of‐study HbA1c levels and >2 weeks of continuous glucose monitoring data collected from 530 adults with Type 1 diabetes or insulin‐requiring Type 2 diabetes during four randomized trials. Each trial lasted ≥24 weeks and provided central laboratory end‐of‐study HbA1c levels and continuous glucose monitoring data from the preceding 3 months. Participants were assigned to groups based on either HbA1c levels or continuous glucose monitoring‐derived glucose values. Results HbA1c was strongly correlated with mean glucose value (r=0.80), time spent with glucose values in the 3.9–10.0 mmol/l range (time in range; r=–0.75) and percentage of glucose values >13.9 mmol/l (r=0.72), but was weakly correlated with the percentage of glucose values <3.9 mmol/l (r=–0.39) or <3.0 mmol/l (r=–0.21). The median percentage of glucose values <3.0 mmol/l was <1.2% (<20 min/day) for all HbA1c‐based groups, but the median percentage of values >13.9 mmol/l varied from 2.5% (0.6 h/day) to 27.8% (6.7 h/day) in the lowest and highest HbA1c groups, respectively. More than 90% of participants with either <2% of glucose values >13.9 mmol/l, mean glucose <7.8 mmol/l, or time in range >80% had HbA1c levels ≤53 mmol/mol (≤7.0%). For participants with HbA1c ≥64 mmol/mol (≥8.0%), the median time in range was 44%, with 90% of participants having a time in range of <59%. Conclusions The associations shown in the present study suggest that continuous glucose monitoring‐derived metrics may help guide diabetes therapy intensification efforts in an HbA1c‐independent manner.
Source: Diabetic Medicine
DOI: 10.1111/dme.14065
Institutions: University of Washington, Dexcom (United States)
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,400
OpenAlex ID: W2954740162