Personalized Hemoglobin A1c (A1c) Shows Better Correlation with Mean Glucose than Laboratory Hemoglobin A1c in Ugandan Youth with Type 1 Diabetes, but Mean Glucose Is Not Clinically Useful in This Population Due to Extreme Glucose Variability
Authors' conclusion
Neither the measured A1c nor the calculated pA1c provided reliable guidance for insulin adjustment in this population. No matter how accurately MG is measured or estimated, it is just an average, with limited clinical application in individuals with wide glycemic variation.
Study context
- Population
- Ugandan youth aged 4–26 years with T1D
- Exposure
- Personalized HbA1c vs laboratory HbA1c for estimating mean glucose
- Outcome
- Relationship with mean glucose (MG)
Methodological detailsblinded continuous glucose monitoring (CGM) sensor wears, CGM data averaged across three blinded sensor wears (31-41 days)
- Blinded CGM sensor wears
- CGM data averaged across three blinded sensor wears (31-41 days)
Main finding
As reported in the abstract
| Group | R2 | R |
|---|---|---|
| Personalized A1c (pA1c) | 0.84 | 0.92 |
| A1c | 0.40 | 0.63 |
R2
Personalized A1c (pA1c)0.84
A1c0.40
R
Personalized A1c (pA1c)0.92
A1c0.63
Observational data: associations, not effects.
Further findings
Glycaemic variability
- Average CV
- 44%
- Mean glucose (MG) >250 mg/dL (13.9 mmol/L)
- 50% of participants
- ≥4% time with glucose <70 mg/dL (3.9 mmol/L)
- 55% of participants
Clinical factors influencing red blood cell (RBC) lifespan
- Clinical factors did not impact the A1c-MG relationship
Original publication
Personalized Hemoglobin A1c Shows Better Correlation with Mean Glucose than Laboratory Hemoglobin A1c in Ugandan Youth with Type 1 Diabetes, but Mean Glucose Is Not Clinically Useful in This Population Due to Extreme Glucose Variability. Diabetes Technol Ther. Published 20 March 2025. doi:10.
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