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dc.contributor.authorChoudhary, Pratik
dc.date.accessioned2022-02-07T10:24:17Z
dc.date.available2022-02-07T10:24:17Z
dc.identifier.citationGomez-Peralta, F., Choudhary, P., Cosson, E., Irace, C., Rami-Merhar, B., & Seibold, A. (2022). Understanding the clinical implications of differences between GMI and HbA1c. Diabetes, obesity & metabolism, 10.1111/dom.14638. Advance online publication.en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12904/15173
dc.description.abstractLaboratory measured glycosylated hemoglobin (HbA1c) is the gold standard for assessing glycemic control in people with diabetes and correlates with their risk of long-term complications. The emergence of continuous glucose monitoring (CGM) has highlighted limitations of HbA1c testing. HbA1c can only be reviewed infrequently and can mask the risk of hypoglycaemia or extreme glucose fluctuations. While CGM provides insights in the risk of hypoglycaemia as well as daily fluctuations of glucose, it can also be used to calculate an estimated HbA1c (eA1c) that has been used as a substitute of laboratory HbA1c. However, it is evident that eA1c and HbA1c values can differ widely. The glucose management indicator (GMI), calculated exclusively from CGM data, has been proposed. It uses the same scale (% or mmol/mol) as HbA1c, but is based on short-term average glucose values, rather than long-term glucose exposure. HbA1c and GMI values differ in up to 81% of individuals by more than ±0.1% and by more than ±0.3% in 51% of cases. Here, we review the factors that define these differences, such as the time period being assessed, the variation in glycation rates and factors such as anaemia and hemoglobinopathies. Recognising and understanding the factors that cause differences between HbA1c and GMI is an important clinical skill. In circumstances when HbA1c is elevated above GMI, further attempts at intensification of therapy based solely on the HbA1c value may increase the risk of hypoglycaemia. The observed difference between GMI and HbA1c also informs the important question about the predictive ability of GMI regarding long term complications.
dc.description.urihttps://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14638en_US
dc.publisherWiley
dc.subjectContinuous glucose monitoringen_US
dc.subjectGlucose management indicatoren_US
dc.subjectHbA1cen_US
dc.subjectaverage glucoseen_US
dc.subjectdiabetesen_US
dc.titleUnderstanding the clinical implications of differences between GMI and HbA1cen_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.versionofrecord10.1111/dom.14638en_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2022-01-04
atmire.accessrights
html.description.abstractLaboratory measured glycosylated hemoglobin (HbA1c) is the gold standard for assessing glycemic control in people with diabetes and correlates with their risk of long-term complications. The emergence of continuous glucose monitoring (CGM) has highlighted limitations of HbA1c testing. HbA1c can only be reviewed infrequently and can mask the risk of hypoglycaemia or extreme glucose fluctuations. While CGM provides insights in the risk of hypoglycaemia as well as daily fluctuations of glucose, it can also be used to calculate an estimated HbA1c (eA1c) that has been used as a substitute of laboratory HbA1c. However, it is evident that eA1c and HbA1c values can differ widely. The glucose management indicator (GMI), calculated exclusively from CGM data, has been proposed. It uses the same scale (% or mmol/mol) as HbA1c, but is based on short-term average glucose values, rather than long-term glucose exposure. HbA1c and GMI values differ in up to 81% of individuals by more than ±0.1% and by more than ±0.3% in 51% of cases. Here, we review the factors that define these differences, such as the time period being assessed, the variation in glycation rates and factors such as anaemia and hemoglobinopathies. Recognising and understanding the factors that cause differences between HbA1c and GMI is an important clinical skill. In circumstances when HbA1c is elevated above GMI, further attempts at intensification of therapy based solely on the HbA1c value may increase the risk of hypoglycaemia. The observed difference between GMI and HbA1c also informs the important question about the predictive ability of GMI regarding long term complications.en_US
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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