Establishing HbA1c -mean blood glucose formulae for patients on continuous ambulatory peritoneal dialysis

To determine the relationship between HbA1c and mean blood glucose concentrations by using HbA1c -mean blood glucose formulae for people on continuous ambulatory peritoneal dialysis.

A total of 305 people on continuous ambulatory peritoneal dialysis, including 13 people with Type 1 diabetes mellitus, 161 people with Type 2 diabetes mellitus and 131 people without diabetes, from a single peritoneal dialysis centre at the First Affiliated Hospital of Sun Yat-sen University, were enrolled between January 2006 and June 2011. Serum HbA1c concentration was measured quarterly and other laboratory variables, including blood glucose, were measured every month. The formulae were established using regression analysis and adjusted for other factors. The estimated blood glucose level calculated using our formulae was compared with that using previous formulae namely the Diabetes Control and Complications Trial and A1c -Derived Average Glucose formulae for people not on dialysis and the Hoshino formula for people on haemodialysis.

The HbA1c -mean blood glucose formulae obtained by linear regression analysis were: 1) mBGmmol/l = 0.107 × HbA1c (mmol/mol) + 1.764 [adjusted R(2) (Radj2)  = 0.494]; 2) mBGmmol/l  = 0.101 × HbA1c  (mmol/mol) - 0.001 × Cr (μmol/l) + 2.850 (Radj2 = 0.507); 3) mBGmmol/l  = 0.102 × HbA1c  (mmol/mol) - 0.095 × Alb (g/l) + 5.394 (Radj2 = 0.521); and 4) mBGmmol/l  = 0.099 × HbA1c (mmol/mol) - 0.001 × Cr (μmol/l)-0.084 × Alb (g/l) + 5.754 (Radj2 = 0.526), where mBG is mean blood glucose, Cr is serum creatinine and Alb is serum albumin. These new formulae performed as well as or better than previous formulae.

The relationship between HbA1c and mean blood glucose for people on continuous ambulatory peritoneal dialysis differs from that for people not on dialysis or for those on haemodialysis. Clinicians and patients can determine glycaemic control targets by applying our formulae.