Abstract
OBJECTIVE: The A1C-Derived Average Glucose (ADAG) study demonstrated a linear relationship between HbA(1c) and mean plasma glucose (MPG). As glucose variability (GV) may contribute to glycation, we examined the association of several glucose variability indices and the MPG-HbA(1c) relationship.
RESEARCH DESIGN AND METHODS: Analyses included 268 patients with type 1 diabetes and 159 with type 2 diabetes. MPG during 3 months was calculated from 7-point self-monitored plasma glucose and continuous glucose monitoring. We calculated three different measures of GV and used a multiple-step regression model to determine the contribution of the respective GV measures to the MPG-HbA(1c) relationship.
RESULTS: GV, as reflected by SD and continuous overlapping net glycemic action, had a significant effect on the MPG-HbA(1c) relationship in type 1 diabetic patients so that high GV led to a higher HbA(1c) level for the same MPG. In type 1 diabetes, the impact of confounding and effect modification of a low versus high SD at an MPG level of 160 mg/dL on the HbA(1c) level is 7.02 vs. 7.43 and 6.96 vs. 7.41. All GV measures showed the same tendency.
CONCLUSIONS: In only type 1 diabetic patients, GV shows a significant interaction with MPG in the association with HbA(1c). This effect is more pronounced at higher HbA(1c) levels. However, the impact of GV on the HbA(1c) level in type 1 diabetes is modest, particularly when HbA(1c) is close to the treatment target of 7%.
| Original language | English |
|---|---|
| Journal | Diabetes Care. Supplement |
| Volume | 34 |
| Issue number | 8 |
| Pages (from-to) | 1843-7 |
| Number of pages | 5 |
| ISSN | 1064-9131 |
| DOIs | |
| Publication status | Published - Aug 2011 |
Keywords
- Adolescent
- Adult
- Aged
- Blood Glucose/metabolism
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 2/blood
- Female
- Glycated Hemoglobin A/metabolism
- Humans
- Male
- Middle Aged
- Young Adult
