Changes in A1C Versus Glucose Management Indicator (GMI) Across Glycemic Categories in Clinical Trials of Type 1 Diabetes
Authors' conclusion
Change in GMI is influenced by the baseline A1C of the participants and it underestimates the true change in A1C. Use of GMI as an endpoint in clinical trials may not reliably capture efficacy of an intervention in T1D trials or real-world studies.
Study context
- Population
- Children, adolescents, adults and older adults with T1D in clinical trials (DCLP3, DCLP5, WISDM)
- Comparison
- Change in A1C vs change in GMI
- Outcome
- Magnitude and direction of changes in A1C vs GMI, overall and by baseline A1C (<7%, 7%-9%, >9%)
- Follow-up
- Baseline-3 months
Pooled result
As reported in the abstract
Change in A1C vs GMI
Correlation between changes in A1C and GMI (r)
0.34
Baseline A1C >9%: larger reduction in A1C than GMI, P < .01
−1.2 [−2.1 to −0.6] vs −0.6 [−0.94 to 0]
Baseline A1C 7%-9%: greater decline in A1C than GMI, P < .01
−0.4 [−0.9 to −0.1] vs −0.12 [−0.49 to 0.21]
Original publication
Changes in A1C Versus GMI Across Glycemic Categories in Clinical Trials of Type 1 Diabetes. J Clin Endocrinol Metab. Published 2 April 2025. doi:10.
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