Discordance Between Glycated Hemoglobin A1c and the Glucose Management Indicator in People With Diabetes and Chronic Kidney Disease
Authors' conclusion
HbA1c-GMI discordance is frequent and usually in favor of an HbA1c level higher than the GMI value, which can lead to errors in changes in glucose-lowering therapy, especially for individuals with CKD. This latter population should benefit from the CGM to measure their glucose exposure more precisely.
Study context
- Population
- Individuals with diabetes using intermittently scanned continuous glucose monitoring (isCGM), with or without chronic kidney disease (CKD)
- Participants
- 170 vs 185
- Exposure
- Diabetes with CKD vs diabetes without CKD
- CKDn = 170
- Without CKDn = 185reference
- Outcome
- Discordance between lab HbA1c and GMI (from 14-day and 90-day isCGM data)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
HbA1c-GMI discordance
| Group | Value | Interval |
|---|---|---|
| CKD | 0.78 ± 0.57 % | 0.66-0.90 |
| Without CKD | 0.59 ± 0.44 % | 0.50-0.66 |
Value
CKD0.78 ± 0.57 %
Without CKD0.59 ± 0.44 %
Interval
CKD0.66-0.90
Without CKD0.50-0.66
- CKD vs Without CKD: P < 0.005 — significantly higher with CKD
Observational data: associations, not effects.
Further findings
Absolute HbA1c-GMI difference >0.5%
Proposed CKD-specific glucose management indicator (GMI) formula (linear regression of hemoglobin A1c (HbA1c) on 90-day mean continuous glucose monitoring (CGM) glucose)
- CKD-GMI = 0.0261 × 90-day mean glucose (mg/L) + 3.5579
- r2 = 0.59
Original publication
Discordance Between Glycated Hemoglobin A1c and the Glucose Management Indicator in People With Diabetes and Chronic Kidney Disease. J Diabetes Sci Technol. Published 25 April 2022. doi:10.
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