Correlation Between Hemoglobin Glycation Index Measured by Continuous Glucose Monitoring With Complications in Type 1
Raul Ibarra-Salce1, Francisco Javier Pozos-Varela1, Nestor Martinez-Zavala1
1Diabetes and Endocrinology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico.
Insights
High hemoglobin glycation index (HGI), measured by continuous glucose monitoring (CGM), may indicate an increased risk of diabetic microvascular complications. This finding suggests HGI could be a valuable tool for assessing diabetes-related health risks.
Area of Science:
- Endocrinology
- Diabetology
- Metabolic Syndrome
Background:
- Hemoglobin A1c (HbA1c) is a standard measure for glycemic control in diabetes, but its correlation with mean glucose levels can be imperfect.
- Continuous glucose monitoring (CGM) offers a more dynamic view of glucose fluctuations.
- The hemoglobin glycation index (HGI) derived from CGM data may provide additional insights into glycemic variability and its impact.
Purpose of the Study:
- To investigate the correlation between CGM-derived HGI and the presence of microvascular complications in individuals with diabetes.
- To compare microvascular complication rates in subgroups with high versus low HGI.
- To assess the predictive value of high HGI for chronic kidney disease (CKD).
Main Methods:
- A cross-sectional study was conducted involving permanent CGM users with type 1 diabetes mellitus or latent autoimmune diabetes of the adult.
- Hemoglobin glycation index (HGI) was calculated, and microvascular complications (diabetic retinopathy, CKD, neuropathy) were assessed.
- Logistic regression analysis was employed to determine the association between high HGI and CKD risk, adjusting for disease duration.
Main Results:
- The study included 52 participants (73.1% women, mean age 39.7 years) with a median HbA1c of 7.6% and GMI of 7.0%.
- Participants with high HGI showed significantly higher HbA1c levels compared to those with low HGI, despite similar mean glucose and GMI.
- Higher occurrences of CKD (25%) and neuropathy (19.2%) were observed in the high HGI group, with high HGI independently associated with an increased risk of CKD (OR: 5.05).
Conclusions:
- CGM-derived HGI may serve as a valuable biomarker for identifying individuals at higher risk of developing microvascular complications in diabetes.
- The HGI offers a complementary perspective to traditional glycemic control measures like HbA1c.
- Further research could explore the clinical utility of HGI in diabetes management and complication screening.
Objective:
HbA1C is the "gold standard" parameter to evaluate glycemic control in diabetes; however, its correlation with mean glucose is not always perfect. The objective of this study was to correlate continuous glucose monitoring (CGM)-derived hemoglobin glycation index (HGI) with microvascular complications.
Methods:
We conducted a cross-sectional study including permanent users of CGM with type 1 diabetes mellitus or latent autoimmune diabetes of the adult. HGI was estimated, and presence of microvascular complications was compared in subgroups with high or low HGI. A logistic regression analysis to assess the contribution of high HGI to chronic kidney disease (CKD) was performed.
Results:
In total, 52 participants who were aged 39.7 ± 14.7 years, with 73.1% women and 15.5 years (IQR, 7.5-29 years) since diagnosis, were included; 32.7% recorded diabetic retinopathy, 25% CKD, and 19.2% neuropathy. The median HbA1C was 7.6% (60 mmol/mol) and glucose management indicator (GMI) 7.0% (53 mmol/mol). The average HGI was 0.55% ± 0.66%. The measured HbA1C was higher in the group with high HGI (8.1% [65 mmol/mol] vs 6.9% [52 mmol/mol]; P < .001), whereas GMI (7.0% [53 mmol/mol] vs 7.0% [53 mmol/mol]; P = .495) and mean glucose were similar in both groups (153 mg/dL vs 153 mg/dL; P = .564). In the high HGI group, higher occurrence of CKD (P = .016) and neuropathy were observed (P = .025). High HGI was associated with increased risk of CKD (odds ratio [OR]: 5.05; 95% CI: 1.02-24.8; P = .04) after adjusting for time since diagnosis (OR: 1.09; 95% CI: 1.02-1.16; P = .008).
Conclusion:
High HGI measured by CGM may be a useful marker for increased risk of microvascular diabetic complications.
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