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- Title
The Relationship Between HbA1c and Mean Plasma Glucose Concentration and the Prediction of a Stable Glycemic Control Target Based on the Use of Continuous Glucose Monitoring System.
- Authors
Rhee, Sang Youl; Kwon, Mi Kwang; Chon, Suk; Jeong, In-Kyung; Oh, Seung Joon; Ahn, Kyu Jeung; Chung, Ho Yeon; Kim, Sung Woon; Kim, Jin-Woo; Kim, Young Seol; Woo, Jeong-Taek
- Abstract
The commonly used relationship between HbA1c (A1c) and the mean plasma glucose (MPG) concentration is based on evidence from the DCCT. However, as the MPG is measured infrequently from capillary blood, its accuracy has some limitations. A recent study on the correlation between the A1c and the MPG measured in 12 diabetic volunteers using CGMS (Medtronic MeniMed, USA) found that the MPG estimate for an A1c of 7% was about 140 mg/dL, which is quite different from the result of the DCCT. In this study, we performed a retrospective analysis of the correlation between the A1c and the MPG from blood glucose measured using CGMS of 145 diabetic subjects. Among these patients, 74 subjects who showed no significant changes in their medication within 3 months of CGMS measurement were chosen as the final enrolled subjects, and the A1c levels of the subjects were measured within 1 month of CGMS measurement. We also investigated that the proportion of CGMS measured glucose ≥ 180 mg/dL and the proportion of CGMS measured glucose <60 mg/dL in each subject. For the study results, the study subjects mean age was 53.8±16.9 years, and the mean diabetes duration was 11.9±7.1 years, and most (91.8%) of the subjects had type 2 diabetes mellitus. The subjects mean A1c level was 8.32±1.77% and their mean MPG measured by CGMS was 185.7±54.2 mg/dL. The mean MPG value measured using a glucometer was 194.1±53.9 mg/dL and the correlation between the former and latter values were high (R=0.96). A linear regression analysis results showed that the correlation between MPG and A1c measured using CGMS could be estimated by the formula (Adjusted for R = 0.60) and accordingly a 7% A1c level would estimate a MPG concentration of 161.0 mg/dL. Furthermore, the MPG values showed a significant alteration with a change in the A1c levels. With an increasing Ale level of subjects, a significant rise was seen in the proportion of CGMS measured glucose ≥ 180 mg/dL and with a decreasing Ale level, a significant rise was seen in the proportion of CGMS measured glucose < 60 mg/dL (p<0.05). Therefore the cut off values for the A1c level and MPG concentration, where the proportion of CGMS measured value that maintained between 60∼180 mg/dL over 90%, were estimated using the ROC curve; an estimate of the A1c level at 6.25% and the MPG at 145.5 mg/dL were calculated.
- Subjects
BLOOD sugar monitoring; BLOOD sugar analysis; PEOPLE with diabetes; DIABETES; GLUCOSE; REGRESSION analysis
- Publication
Diabetes, 2007, Vol 56, pA111
- ISSN
0012-1797
- Publication type
Article