Discordance Between HbA1c and Glucose Management Indicator in People With Type 2 Diabetes Treated With SGLT2...

Area of Science:

• Endocrinology
• Metabolic Diseases
• Diabetes Management

Background:

• The hemoglobin glycation index (HGI) assesses discordance between HbA1c and continuous glucose monitoring (CGM)-derived glucose management indicator (GMI).
• The effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on HGI and other glycemic markers is not well understood.

Purpose of the Study:

• To investigate the impact of SGLT2i on HGI and the glycated albumin-to-HbA1c (GA/HbA1c) ratio in individuals with type 2 diabetes.
• To determine if SGLT2i use independently influences these glycemic markers.

Main Methods:

• Retrospective analysis of CGM data from 143 individuals with type 2 diabetes, stratified by SGLT2i use.
• Comparison of HGI and GA/HbA1c ratios between SGLT2i users and non-users.
• Multivariate analyses adjusting for clinical and laboratory parameters.

Main Results:

• SGLT2i users showed significantly higher HGI and lower GA/HbA1c ratios compared to non-users.
• SGLT2i use was an independent determinant of both higher HGI and lower GA/HbA1c ratio.
• The relationship between HbA1c and GMI differed significantly between groups, while the GA-GMI relationship remained consistent.

Conclusions:

• SGLT2i therapy alters the interpretation of glycemic control markers.
• Elevated HGI and reduced GA/HbA1c ratio due to SGLT2i are independent of hematologic and renal factors.
• Individualized assessment using CGM-derived metrics and complementary biomarkers is crucial for patients on SGLT2i therapy.