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Discordance between Glucose Management Indicator and Glycated Hemoglobin in a Pediatric Cohort with Type 1 Diabetes:

Simone Foti Randazzese1, Bruno Bombaci1, Serena Costantino1

  • 1Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy.

Children (Basel, Switzerland)
|February 24, 2024
PubMed

Insights

Continuous glucose monitoring (CGM) in type 1 diabetes (T1D) shows variability. Glycemic management indicator (GMI) discrepancies highlight the continued importance of glycated hemoglobin (HbA1c) for accurate glucose control assessment.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pediatric Diabetes Management

Background:

  • Continuous glucose monitoring (CGM) offers detailed glycemic insights for type 1 diabetes (T1D) management.
  • However, CGM-derived glucose control indicators can sometimes be inaccurate.
  • Assessing discrepancies between CGM-based metrics and traditional markers is crucial.

Purpose of the Study:

  • To evaluate the difference between the glucose management indicator (GMI) and glycated hemoglobin (HbA1c) (ΔGMI-HbA1c) in pediatric T1D patients.
  • To explore correlations between ΔGMI-HbA1c and other CGM metrics and blood count parameters.
  • To understand the clinical implications of GMI-HbA1c discrepancies in T1D management.

Main Methods:

  • A single-center, cross-sectional study involving 128 children and adolescents with T1D.
  • Collection of demographic data, blood count parameters, HbA1c values, and CGM metrics.
  • Analysis of the discrepancy (ΔGMI-HbA1c) and its association with CGM variability and blood parameters.

Main Results:

  • Higher coefficient of variation (CV) and time above range (>250 mg/dL) were observed in subjects with ΔGMI-HbA1c > 0.3%.
  • No significant association was found between blood count parameters and ΔGMI-HbA1c.
  • The findings indicate potential inaccuracies in CGM-derived GMI in certain T1D subgroups.

Conclusions:

  • Despite CGM advancements, HbA1c remains essential for assessing glycemic control in T1D.
  • HbA1c is particularly important for individuals with suboptimal metabolic control and high glycemic variability.
  • Understanding GMI-HbA1c discrepancies is key to refining diabetes management strategies.

Keywords:
adolescentautomated insulin deliveryblood countchildrencontinuous glucose monitoringglycemic variabilityglycosylationhybrid closed loopinsulintime in range

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