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Managing discordance between HbA1c and glucose management indicator

Erna Lenters-Westra1,2, Marion Fokkert1, Eric S Kilpatrick3

  • 1Department of Clinical Chemistry, Isala, Zwolle, the Netherlands.

Diabetic Medicine : a Journal of the British Diabetic Association
|March 24, 2025
PubMed

Insights

Discrepancies between HbA1c and Glucose Management Indicator (GMI) can impact diabetes care. This checklist helps identify and mitigate errors from Continuous Glucose Monitoring (CGM) and HbA1c measurements for improved patient outcomes.

Area of Science:

  • Endocrinology and Metabolism
  • Clinical Diagnostics
  • Biomedical Engineering

Background:

  • Hemoglobin A1c (HbA1c) is crucial for diabetes management.
  • Continuous Glucose Monitoring (CGM) offers real-time glucose data.
  • Discordance between HbA1c and Glucose Management Indicator (GMI) presents clinical challenges.

Purpose of the Study:

  • To present a checklist of potential error sources for GMI and HbA1c values.
  • To provide mitigation strategies for identified discrepancies.
  • To enhance the accuracy of glycaemic control assessment in diabetes care.

Main Methods:

  • Literature review on GMI and HbA1c measurement techniques.
  • Identification of factors contributing to discordance between GMI and HbA1c.
  • Development of a reference checklist for error mitigation.

Main Results:

  • A checklist detailing common sources of discordance between HbA1c and GMI has been developed.
  • Factors include Continuous Glucose Monitoring (CGM) accuracy and sensor calibration.
  • Physiological conditions and red blood cell turnover also contribute to discrepancies.

Conclusions:

  • Glucose Management Indicator (GMI) is increasingly utilized in diabetes care.
  • Understanding potential causes of GMI and HbA1c discordance is essential for CGM users.
  • Equipping patients and providers with knowledge improves diabetes management.
Abstract

Keywords:
GMIHbA1cdiabetesdiscordance

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