Correlation Between Hemoglobin Glycation Index Measured by Continuous Glucose Monitoring With Complications in Type 1 Diabetes

• Published in: Endocrine practice Vol. 29; no. 3; p. 162
• Main Authors: Ibarra-Salce, Raul, Pozos-Varela, Francisco Javier, Martinez-Zavala, Nestor, Lam-Chung, Cesar Ernesto, Mena-Ureta, Tania Sofia, Janka-Zires, Marcela, Faradji, Raquel N, Madrigal-Sanroman, Juan Ramon, de la Garza-Hernandez, Natalia Eloisa, Almeda-Valdes, Paloma
• Format: Journal Article
• Language: English
• Published: United States 01-03-2023
• Subjects: Adult; Blood Glucose; Blood Glucose Self-Monitoring; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 2 - complications; Female; Glycated Hemoglobin; Hemoglobins; Humans; Maillard Reaction; Male; Renal Insufficiency, Chronic; continuous glucose monitoring; hemoglobin glycation index; microvascular complications
• ISSN: 1530-891X
• DOI: 10.1016/j.eprac.2023.01.001

HbA1C is the "gold standard" parameter to evaluate glycemic control in diabetes; however, its correlation with mean glucose is not always perfect. The objective of this study was to correlate continuous glucose monitoring (CGM)-derived hemoglobin glycation index (HGI) with microvascular complications.
We conducted a cross-sectional study including permanent users of CGM with type 1 diabetes mellitus or latent autoimmune diabetes of the adult. HGI was estimated, and presence of microvascular complications was compared in subgroups with high or low HGI. A logistic regression analysis to assess the contribution of high HGI to chronic kidney disease (CKD) was performed.
In total, 52 participants who were aged 39.7 ± 14.7 years, with 73.1% women and 15.5 years (IQR, 7.5-29 years) since diagnosis, were included; 32.7% recorded diabetic retinopathy, 25% CKD, and 19.2% neuropathy. The median HbA1C was 7.6% (60 mmol/mol) and glucose management indicator (GMI) 7.0% (53 mmol/mol). The average HGI was 0.55% ± 0.66%. The measured HbA1C was higher in the group with high HGI (8.1% [65 mmol/mol] vs 6.9% [52 mmol/mol]; P < .001), whereas GMI (7.0% [53 mmol/mol] vs 7.0% [53 mmol/mol]; P = .495) and mean glucose were similar in both groups (153 mg/dL vs 153 mg/dL; P = .564). In the high HGI group, higher occurrence of CKD (P = .016) and neuropathy were observed (P = .025). High HGI was associated with increased risk of CKD (odds ratio [OR]: 5.05; 95% CI: 1.02-24.8; P = .04) after adjusting for time since diagnosis (OR: 1.09; 95% CI: 1.02-1.16; P = .008).
High HGI measured by CGM may be a useful marker for increased risk of microvascular diabetic complications.