Original Research
Original Research
Assessment of Clinical Factors Influencing Glucose Management Indicator and Glycated Hemoglobin Discordance in Children With Type One Diabetes: A One-Year, Real-world Data Observation
Discordances between glucose management indicator coming from continuous glucose monitoring report and laboratory glycated hemoglobin still exist.
Our one-year study shows a greater difference is more likely to occur in individuals with a higher glycated hemoglobin value, longer diabetes duration, and less stable glycemic management.
Individual discordance between glycated hemoglobin and glucose management indicator from ninety days of data was stable in two-thirds of patients, although with varying degrees of difference.
Our observations can provide practical guidance during ongoing treatment evaluation.
ABSTRACT
ABSTRACT
Objectives: Published data still highlight discordances between glucose management indicator (the parameter estimating glycated hemoglobin from continuous glucose monitoring reporting) and laboratory glycated hemoglobin, for reasons yet to be explored. In our study we aimed to identify potential clinical factors contributing to these discordances.
Methods: A retrospective study of ninety-nine children (mean twelve point nine two years) was conducted using continuous glucose monitoring devices. Inclusion criteria for patients were type one diabetes, continuous use of one type of continuous glucose monitoring (with more than seventy percent sensor activity) over the previous year, and quarterly visits. At each visit, we collected data for age, sex, body mass index, diabetes duration, daily insulin dose, continuous glucose monitoring report (fourteen of ninety days), and laboratory glycated hemoglobin.
Results: We confirmed linear dependency between glycated hemoglobin and glucose management indicator-that is, higher glycated hemoglobin led to more glycated hemoglobin-glucose management indicator differences. The glycated hemoglobin-glucose management indicator ninety-day discordance was categorized into four thresholds: forty-eight point seven percent at less than zero point two five, twenty point one percent between zero point two five and zero point five, twenty-two point four percent between zero point five and zero point seven five, and eight point seven percent at greater than zero point seven five. Children with glycated hemoglobin-glucose management indicator ninety discordance less than zero point five percent had significantly lower glycated hemoglobin (six point eight zero percent versus seven point five nine percent), shorter type one diabetes duration (less than five years), and more stable glycated hemoglobin (differences less than zero point four between results). The analysis of participants' stability based on comparing glycated hemoglobin-glucose management indicator ninety discordances at subsequent follow-up visits confirmed an individual variability of less than zero point two five in two-thirds of participants. Other factors were not associated with the glycated hemoglobin-glucose management indicator discordance.
Conclusions: One-year, real-world data show that clinically significant discordances (glycated hemoglobin-glucose management indicator ninety greater than zero point five percent) occurred in less than thirty percent of the children. A greater difference is more likely in individuals with higher glycated hemoglobin, longer diabetes duration, and less stable glycemic management. Individual glycated hemoglobin-glucose management indicator ninety discordance was mostly stable, although with varying degrees of difference.