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Published on: June 11, 2012

Interpreting Glucose Management Indicator and Point-of-Care Hemoglobin A1c Discrepancies in Pediatric Patients with

Bella London1, Lindsey Hornung2, Deborah Elder1,3

  • 1Department of Endocrinology, College of Medicine, University of Cincinnati, Cincinnati Children's Hospital Medical Center, OH, USA.

Journal of Diabetes Science and Technology
|July 20, 2026
PubMed

Insights

Glucose management indicator (GMI) may differ from hemoglobin A1c (A1c) post-total pancreatectomy with islet auto transplantation (TPIAT). This GMI-A1c discrepancy can affect insulin weaning decisions in TPIAT patients.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Transplantation Medicine

Background:

  • Glucose management indicator (GMI) is frequently used in telehealth without paired hemoglobin A1c (A1c) measurements.
  • Discrepancies between GMI and A1c can influence critical decisions, such as insulin weaning, in patients post-total pancreatectomy with islet auto transplantation (TPIAT).

Purpose of the Study:

  • To compare point-of-care (POC) A1c with 14-day GMI levels at 1-year post-TPIAT.
  • To evaluate the impact of GMI-A1c discrepancies on insulin management strategies in this specific patient population.

Main Methods:

  • Retrospective review of medical records for 33 patients 1-year post-TPIAT who had both POC A1c and continuous glucose monitoring (CGM) data.
  • Patients were stratified into two groups based on POC A1c: <6.5% and ≥6.5%.

Main Results:

  • Median POC A1c was 6.0%, while median 14-day GMI was significantly higher at 6.5% (P < .0001).
  • The GMI was 0.5% higher than POC A1c in the <6.5% A1c group, versus no significant difference in the ≥6.5% A1c group (P < .0001).

Conclusions:

  • Significant discordance exists between 14-day GMI and POC A1c in TPIAT patients 1-year post-surgery, especially when A1c is below 6.5%.
  • This discordance, if GMI is used alone, could significantly impact clinical decisions regarding insulin therapy weaning in this vulnerable population.
Abstract

Keywords:
A1cCGMGMITPIATdiscordance

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