(04-02-11) Hemoglobin A1c and Mean Glucose in Patients With Type 1 Diabetes: Analysis of data from the Juvenile Diabetes Research Foundation co

Hemoglobin A1c and Mean Glucose in Patients With Type 1 Diabetes: Analysis of data from the Juvenile Diabetes Research Foundation continuous glucose monitoring randomized trial.


Wilson DM, Xing D, Beck RW, Block J, Bode B, Fox LA, Hirsch I, Kollman C,
Laffel L, Ruedy KJ, Steffes M, Tamborlane WV; Juvenile Diabetes Research
Foundation Continuous Glucose Monitoring Study Group*.

Stanford University, Stanford, California.
Abstract
OBJECTIVE To determine the relationship between mean sensor glucose
concentrations and hemoglobin A(1c) (HbA(1c)) values measured in the Diabetes
Control and Complications Trial/Epidemiology of Diabetes Interventions and
Complications laboratory at the University of Minnesota in a cohort of subjects
with type 1 diabetes from the Juvenile Diabetes Research Foundation continuous
glucose monitoring randomized trial. RESEARCH DESIGN AND METHODS Near-
continuous glucose sensor data (??4 days/week) were collected for 3 months
before a central laboratory-measured HbA(1c) was performed for 252 subjects
ages 8-74 years, the majority of whom had stable HbA(1c) values (77% within ??0.
4% of the patient mean). RESULTS The slope (95% CI) for mean sensor glucose
concentration (area under the curve) versus a centrally measured HbA(1c) was
24.4 mg/dL (22.0-26.7) for each 1% change in HbA(1c), with an intercept of
-16.2 mg/dL (-32.9 to 0.6). Although the slope did not vary with age or sex,
there was substantial individual variability, with mean sensor glucose
concentrations ranging from 128 to 187 mg/dL for an HbA(1c) of 6.9-7.1%. The
root mean square of the errors between the actual mean sensor glucose
concentration versus the value calculated using the regression equation was
14.3 mg/dL, whereas the median absolute difference was 10.1 mg/dL. CONCLUSIONS
There is substantial individual variability between the measured versus
calculated mean glucose concentrations. Consequently, estimated average glucose
concentrations calculated from measured HbA(1c) values should be used with
caution.

Source: Diabetes Care. 2011 Jan 25. [Epub ahead of print]

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