High-Amplitude and Prolonged Glucose Excursions as a Key Determinant of Discordance Between Glucose Management Indicator and Glycated Hemoglobin in Type 1 Diabetes
Authors' conclusion
Frequent high and prolonged glucose excursions were consistently associated with GMI-HbA1c discordance across devices, HbA1c strata, and analytic conditions. GRID-derived excursion metrics modify the relationship between GMI/uGMI and glycemia-associated risk.
Study context
- Population
- Adults with T1D with 90-day continuous glucose monitoring (CGM) traces paired with hemoglobin A1c (HbA1c) within ±15 days
- Participants
- 611 adults
- Outcome
- Association of excursions (peak glucose ≥250 mg/dL, time to peak ≥90 min) with uGMI-to-HbA1c ratio
Methodological detailsExcursions quantified with the glucose rate increase detector (GRID) algorithm; discordance defined by glucose management indicator (GMI)-to-HbA1c and updated GMI (uGMI)-to-HbA1c ratios
- Excursions quantified with the glucose rate increase detector (GRID) algorithm; discordance defined by GMI-to-HbA1c and uGMI-to-HbA1c ratios
Main finding
As reported in the abstract
Sensor type 1: β
0.174
95% CI 0.147–0.201P < 0.001
Sensor type 2: β
0.102
95% CI 0.068–0.136P < 0.001
Observational data: associations, not effects.
Further findings
Associations of HbA1c, GMI and uGMI with albuminuria and elevated triglyceride-glucose index (restricted cubic spline)
- Adjustment for GRID-derived excursion metrics differentially reshaped the associations, preferentially enhancing the informativeness of GMI and uGMI but not HbA1c
Original publication
High-Amplitude and Prolonged Glucose Excursions as a Key Determinant of Discordance Between Glucose Management Indicator and Glycated Hemoglobin in Type 1 Diabetes. Diabetes Care. Published 4 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →