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Glucose Management Indicator (GMI): A New Term for Estimating A1C From Continuous Glucose Monitoring
Richard M Bergenstal1, Roy W Beck2, Kelly L Close3
1International Diabetes Center Park Nicollet, Minneapolis, MN richard.bergenstal@parknicollet.com.
Diabetes Care
|September 19, 2018
Summary
The glucose management indicator (GMI) replaces estimated A1C (eA1C) for better diabetes management using continuous glucose monitoring (CGM). This new metric and formula improve understanding and clinical use of CGM data alongside traditional A1C measurements.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Medical Technology
Background:
- A1C is a key diabetes risk marker, but its correlation with continuous glucose monitoring (CGM) metrics needs clarification.
- Estimated A1C (eA1C) converts mean glucose from CGM or self-monitored blood glucose readings to an estimated lab A1C.
- Discrepancies between eA1C and lab A1C can cause confusion for patients and clinicians.
Purpose of the Study:
- To address the need for a standardized metric reflecting CGM data's impact on glycemic control.
- To introduce the Glucose Management Indicator (GMI) as a successor to eA1C.
- To provide guidance on interpreting and utilizing GMI in diabetes management and education.
Main Methods:
- Renaming eA1C to GMI based on FDA recommendations and clinical consensus.
- Developing a new formula for GMI calculation using recent clinical trial data and advanced CGM systems.
- Analyzing and explaining new CGM metrics and their interpretation in relation to GMI.
Main Results:
- The GMI offers a standardized way to estimate A1C from CGM data.
- A revised formula enhances the accuracy of GMI conversion from mean glucose.
- New analytical approaches facilitate understanding and clinical application of GMI.
Conclusions:
- The GMI provides a valuable, clearer metric for diabetes management, improving upon eA1C.
- Effective interpretation and application of GMI can enhance patient education and clinical decision-making.
- This transition supports the integration of CGM data into routine diabetes care.
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