Hemoglobin A1c and mean glucose in patients with type 1 diabetes: Analysis of data from the juvenile diabetes research foundation continuous glucose monitoring randomized trial

Darrell M. Wilson, Dongyuan Xing, Roy W. Beck, Jennifer Block, Bruce Bode, Larry A. Fox, Irl Hirsch, Craig Kollman, Lori Laffel, Katrina J. Ruedy, Michael Steffes, William V. Tamborlane

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Abstract

OBJECTIVE - To determine the relationship between mean sensor glucose concentrations and hemoglobin A1c (HbA1c) values measured in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications laboratory at the University of Minnesota in a cohort of subjects with type 1 diabetes from the Juvenile Diabetes Research Foundation continuous glucose monitoring randomized trial. RESEARCH DESIGN AND METHODS - Near-continuous glucose sensor data (≥4 days/week) were collected for 3 months before a central laboratory-measured HbA1c was performed for 252 subjects aged 8-74 years, the majority of whom had stable HbA 1c values (77% within 60.4% of the patient mean). RESULTS - The slope (95% CI) for mean sensor glucose concentration (area under the curve) versus a centrally measured HbA1c was 24.4 mg/dL (22.0-26.7) for each 1% change in HbA1c, with an intercept of -16.2 mg/dL (-32.9 to 0.6). Although the slope did not vary with age or sex, there was substantial individual variability, with mean sensor glucose concentrations ranging from 128 to 187 mg/dL for an HbA1c of 6.9-7.1%. The root mean square of the errors between the actual mean sensor glucose concentration versus the value calculated using the regression equation was 14.3 mg/dL, whereas the median absolute difference was 10.1 mg/dL. CONCLUSIONS - There is substantial individual variability between the measured versus calculated mean glucose concentrations. Consequently, estimated average glucose concentrations calculated from measured HbA1c values should be used with caution.

Original languageEnglish (US)
Pages (from-to)540-544
Number of pages5
JournalDiabetes care
Volume34
Issue number3
DOIs
StatePublished - Mar 1 2011

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    Wilson, D. M., Xing, D., Beck, R. W., Block, J., Bode, B., Fox, L. A., Hirsch, I., Kollman, C., Laffel, L., Ruedy, K. J., Steffes, M., & Tamborlane, W. V. (2011). Hemoglobin A1c and mean glucose in patients with type 1 diabetes: Analysis of data from the juvenile diabetes research foundation continuous glucose monitoring randomized trial. Diabetes care, 34(3), 540-544. https://doi.org/10.2337/dc10-1054