Association of time in range with hemoglobin A1c, glycated albumin and 1,5-anhydro-d-glucitol

J Diabetes Investig. 2021 Jun;12(6):940-949. doi: 10.1111/jdi.13437. Epub 2020 Nov 15.

Abstract

Aims/introduction: Hemoglobin A1c (HbA1c), glycated albumin (GA) and 1,5-anhydro-d-glucitol (1,5-AG) are used as indicators of glycemic control, whereas continuous glucose monitoring (CGM) is used to assess daily glucose profiles. The aim of this study was to investigate the relationships between CGM metrics, such as time in range (TIR), and glycemic control indicators.

Materials and methods: We carried out retrospective CGM and blood tests on 189 outpatients with impaired glucose tolerance (n = 22), type 1 diabetes mellitus (n = 67) or type 2 diabetes mellitus (n = 100).

Results: In type 1 diabetes mellitus and type 2 diabetes mellitus patients, HbA1c and GA were negatively correlated with TIR, whereas 1,5-AG was positively correlated with TIR. In type 1 diabetes mellitus patients, a TIR of 70% corresponded to HbA1c, GA and 1,5-AG of 6.9% (95% confidence interval [CI] 6.5-7.2%), 20.3% (95% CI 19.0-21.7%) and 6.0 µg/mL (95% CI 5.1-6.9 µg/mL), respectively. In type 2 diabetes mellitus patients, a TIR of 70% corresponded to HbA1c, GA and 1,5-AG of 7.1% (95% CI 7.0-7.3%), 19.3% (95% CI 18.7-19.9%) and 10.0 µg/mL (95% CI 9.0-11.0 µg/mL), respectively. TIR values corresponding to HbA1c levels of 7.0% were 56.1% (95% CI 52.3-59.8%) and 74.2% (95% CI 71.3-77.2%) in type 1 diabetes mellitus and type 2 diabetes mellitus patients, respectively.

Conclusions: The results of this study showed that the estimated HbA1c corresponding to a TIR of 70% was approximately 7.0% for both type 1 diabetes mellitus and type 2 diabetes mellitus patients, and that the estimated 1,5-AG calculated from the TIR of 70% might be different between type 1 diabetes mellitus and type 2 diabetes mellitus patients.

Keywords: Continuous glucose monitoring; Hemoglobin A1c; Time in range.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Blood Glucose Self-Monitoring / statistics & numerical data
  • Deoxyglucose / analysis*
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 2 / blood
  • Female
  • Glucose Intolerance / blood
  • Glucose Metabolism Disorders / blood*
  • Glycated Hemoglobin / analysis*
  • Glycated Serum Albumin
  • Glycation End Products, Advanced
  • Glycemic Control / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Serum Albumin / analysis*
  • Time Factors

Substances

  • Glycated Hemoglobin A
  • Glycation End Products, Advanced
  • Serum Albumin
  • 1,5-anhydroglucitol
  • Deoxyglucose
  • Glycated Serum Albumin