Association of HbA1c and an updated glucose management indicator (uGMI) with incident diabetic retinopathy in adults with type 1 diabetes: a longitudinal study
Authors' conclusion
The uGMI is a slightly stronger predictor of diabetic retinopathy risk compared with HbA1c. HbA1c and uGMI do not appear to be complementary for diabetic retinopathy risk prediction.
Study context
- Population
- Adults with T1D with incident DR (cases) or no retinopathy (controls)
- Comparison
- uGMI vs HbA1c for predicting incident DR
- Outcome
- Predictive performance for incident DR risk (association with incident DR)
Methodological detailssecondary use of previously published longitudinal case-control data, continuous glucose monitoring (CGM) data up to 7 years before diagnosis
- Secondary use of previously published longitudinal case-control data
- CGM data up to 7 years before diagnosis
Main finding
As reported in the abstract
Prediction of incident DR
| Group | Mutual information scores (MIS) | AUC |
|---|---|---|
| uGMI | 0.148 | 0.733 |
| HbA1c | 0.078 | 0.704 |
Mutual information scores (MIS)
uGMI0.148
HbA1c0.078
AUC
uGMI0.733
HbA1c0.704
Observational data: associations, not effects.
Further findings
Combined HbA1c and uGMI (decision tree models)
- Models incorporating both HbA1c and uGMI did not improve clinically significant DR risk prediction
Machine learning models
- Better predictive value of uGMI confirmed, especially for HbA1c 54 mmol/mol (7.1% NGSP) to 58 mmol/mol (7.5% NGSP), where DR risk escalated significantly
Original publication
Association of HbA1c and an updated glucose management indicator (uGMI) with incident diabetic retinopathy in adults with type 1 diabetes: a longitudinal study. Diabetologia. Published 11 November 2025. doi:10.
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