Discordance between mean glucose and time in range in relation to HbA1c in individuals with type 1 diabetes: results from the GOLD and SILVER trials
Authors' conclusion
Inter-individual variations exist between MG and HbA1c, as well as between TIR and HbA1c, with clinically important deviations in relatively large groups of individuals with type 1 diabetes. These results may provide important information to both healthcare providers and individuals with diabetes in terms of prognosis and when making diabetes management decisions.
Study context
- Population
- Adults with T1D in the randomised GOLD trial and the follow-up SILVER trial, followed for 2.5 years; GOLD: mean age 44±13 years, 44% female, mean HbA1c 72±9.8 mmol/mol (8.7±0.9%)596 paired HbA1c/CGM measurements
- Primary endpoint
- Association of MG and TIR with HbA1c
Methodological detailslinear mixed-effects models, repeated measures
- Linear mixed-effects models
- Repeated measures
Primary result
As reported in the abstract
- Variation in HbA1c explained by MG (r=0.79, p<0.001)
- 63%
- Variation in HbA1c explained by MG accounting for person-to-person variation (r=0.94, p value for improvement of fit <0.001)
- 88%
- Individuals whose HbA1c deviated by >8 mmol/mol (0.8%) from estimated HbA1c for a given MG and time in range (TIR)
- 10%
- At a given TIR, HbA1c lower per 1% increase in time below range (TBR)
- 0.6 mmol/mol (95% CI 0.4, 0.9; p<0.001)
- At a given TIR, HbA1c higher per 2% increase in time above range (TAR) level 2
- 0.4 mmol/mol (95% CI 0.1, 0.6; p=0.003)
Original publication
Discordance between mean glucose and time in range in relation to HbA1c in individuals with type 1 diabetes: results from the GOLD and SILVER trials. Diabetologia. Published 26 April 2024. doi:10.
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