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Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA(1c) Levels in Type 1 and Type 2 Diabetic Patients?
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. RESE...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142023/ https://www.ncbi.nlm.nih.gov/pubmed/21700921 http://dx.doi.org/10.2337/dc10-2217 |
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author | Kuenen, Judith C. Borg, Rikke Kuik, Dirk J. Zheng, Hui Schoenfeld, David Diamant, Michaela Nathan, David M. Heine, Robert J. |
author_facet | Kuenen, Judith C. Borg, Rikke Kuik, Dirk J. Zheng, Hui Schoenfeld, David Diamant, Michaela Nathan, David M. Heine, Robert J. |
author_sort | Kuenen, Judith C. |
collection | PubMed |
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%. |
format | Online Article Text |
id | pubmed-3142023 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-31420232012-08-01 Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA(1c) Levels in Type 1 and Type 2 Diabetic Patients? Kuenen, Judith C. Borg, Rikke Kuik, Dirk J. Zheng, Hui Schoenfeld, David Diamant, Michaela Nathan, David M. Heine, Robert J. Diabetes Care Original Research 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%. American Diabetes Association 2011-08 2011-07-16 /pmc/articles/PMC3142023/ /pubmed/21700921 http://dx.doi.org/10.2337/dc10-2217 Text en © 2011 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
spellingShingle | Original Research Kuenen, Judith C. Borg, Rikke Kuik, Dirk J. Zheng, Hui Schoenfeld, David Diamant, Michaela Nathan, David M. Heine, Robert J. Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA(1c) Levels in Type 1 and Type 2 Diabetic Patients? |
title | Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA(1c) Levels in Type 1 and Type 2 Diabetic Patients? |
title_full | Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA(1c) Levels in Type 1 and Type 2 Diabetic Patients? |
title_fullStr | Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA(1c) Levels in Type 1 and Type 2 Diabetic Patients? |
title_full_unstemmed | Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA(1c) Levels in Type 1 and Type 2 Diabetic Patients? |
title_short | Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA(1c) Levels in Type 1 and Type 2 Diabetic Patients? |
title_sort | does glucose variability influence the relationship between mean plasma glucose and hba(1c) levels in type 1 and type 2 diabetic patients? |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142023/ https://www.ncbi.nlm.nih.gov/pubmed/21700921 http://dx.doi.org/10.2337/dc10-2217 |
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