Does Glucose Variability Influence the Relationship Between Mean Plasma Glucose and HbA1c Levels in Type 1 and Type 2 Diabetic Patients?  

Oleh:

Kuenen, Judith C. ; Borg, Rikke ; Kuik, Dirk J. ; Zheng, Hui

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 34 no. 08 (Aug. 2011), page 1843-1847 .
Topik: DIABETES; Mean Plasma Glucose; Glucose Variability

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

OBJECTIVE The A1C-Derived Average Glucose (ADAG) study demonstrated a linear relationship between HbA1c 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-HbA1c 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-HbA1c relationship. RESULTS GV, as reflected by SD and continuous overlapping net glycemic action, had a significant effect on the MPG-HbA1c relationship in type 1 diabetic patients so that high GV led to a higher HbA1c 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 HbA1c 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 HbA1c. This effect is more pronounced at higher HbA1c levels. However, the impact of GV on the HbA1c level in type 1 diabetes is modest, particularly when HbA1c is close to the treatment target of 7%.

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