Comparative Analysis of Capillary Hemoglobin A1c (HbA1c) and CGM-Derived Glucose Management Indicator (GMI) Estimates: A Real-World Data from a Single Center
Authors' conclusion
A significant number of participants exhibited discrepancies between HbA1c and GMI. This discrepancy was unrelated to CGM sampling duration and stable within individuals, suggesting intrinsic factors may contribute. HbA1c and GMI each reflect different aspects of glycemic control, and neither is sufficient alone. Combining HbA1c with CGM-derived metrics, such as TING, may provide a more accurate and comprehensive assessment of glycemic exposure.
Study context
- Population
- Youth with T1D; mean age 15.85 ± 5.99 years, 56% male, median HbA1c 7.4% (IQR 6.7–8.1); two paired measurements per individual
- Participants
- 270 participants
- Exposure
- Capillary HbA1c vs continuous glucose monitoring (CGM)-derived GMI
- Outcome
- Discrepancy between paired capillary HbA1c and GMI
Methodological detailsobservational, single-centre, real-world data
- Observational
- Single-centre
- Real-world data
Main finding
As reported in the abstract
Discrepancy >0.5%
37.3%
Discrepancy >1%
11.8%
Proportional bias (HbA1c underestimating GMI at lower values, overestimating at higher values)
β = 0.260
P < 0.001
Observational data: associations, not effects.
Further findings
Factors associated with discrepancy
- Glucose-6-phosphate dehydrogenase deficiency prevalence; consistently correlated with discrepancies >1% in all measurements
- 1.9%
- No significant correlation of discrepancies with age, sex, BMI and disease duration
CGM metrics associated with HbA1c
- Mean glucose, GMI and time in normal glucose (TING, 70-140 mg/dL) showed similar associations with HbA1c; TIR slightly lower magnitude of association
Original publication
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