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Does glucose variability influence the relationship between mean plasma glucose and HbA1c levels in type 1 and type 2 diabetic patients?

Title: Does glucose variability influence the relationship between mean plasma glucose and HbA1c levels in type 1 and type 2 diabetic patients?
Authors: Kuenen JC; Borg R; Kuik DJ; Zheng H; Schoenfeld D; Diamant M; Nathan DM; Heine RJ; SARTORE, GIOVANNI; LAPOLLA, ANNUNZIATA
Contributors: Kuenen, Jc; Borg, R; Kuik, Dj; Zheng, H; Schoenfeld, D; Diamant, M; Nathan, Dm; Heine, Rj; Sartore, Giovanni; Lapolla, Annunziata
Publication Year: 2011
Collection: Padua Research Archive (IRIS - Università degli Studi di Padova)
Description: OBJECTIVE: The A1C-Derived Average Glucose (ADAG) study demonstrated a linear relationship between HbA(1c) and mean plasma glucose (MPG). As glucose variability (GV) may contribute to glycation, we examined the association of several glucose variability indices and the MPG-HbA(1c) relationship. RESEARCH DESIGN AND METHODS: Analyses included 268 patients with type 1 diabetes and 159 with type 2 diabetes. MPG during 3 months was calculated from 7-point self-monitored plasma glucose and continuous glucose monitoring. We calculated three different measures of GV and used a multiple-step regression model to determine the contribution of the respective GV measures to the MPG-HbA(1c) relationship. RESULTS: GV, as reflected by SD and continuous overlapping net glycemic action, had a significant effect on the MPG-HbA(1c) relationship in type 1 diabetic patients so that high GV led to a higher HbA(1c) level for the same MPG. In type 1 diabetes, the impact of confounding and effect modification of a low versus high SD at an MPG level of 160 mg/dL on the HbA(1c) level is 7.02 vs. 7.43 and 6.96 vs. 7.41. All GV measures showed the same tendency. CONCLUSIONS: In only type 1 diabetic patients, GV shows a significant interaction with MPG in the association with HbA(1c). This effect is more pronounced at higher HbA(1c) levels. However, the impact of GV on the HbA(1c) level in type 1 diabetes is modest, particularly when HbA(1c) is close to the treatment target of 7%.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/21700921; info:eu-repo/semantics/altIdentifier/wos/WOS:000294035400031; volume:34(8); firstpage:1843; lastpage:1847; numberofpages:5; journal:DIABETES CARE; https://hdl.handle.net/11577/2533164
DOI: 10.2337/dc10-2217
Availability: https://hdl.handle.net/11577/2533164; https://doi.org/10.2337/dc10-2217
Accession Number: edsbas.F049FF2E
Database: BASE