Associations Between HbA1c and Glucose Time in Range Using Continuous Glucose Monitoring in Type 1 Diabetes: Cross-Sectional Population-Based Study

• Introduction Continuous glucose monitoring (CGM) introduces novel indicators of glycemic control.Methods This cross-sectional study, based on the Swedish National Diabetes Register, examines 27,980 adults with type 1 diabetes. It explores the relationships between HbA1c (glycated hemoglobin) and various CGM-derived metrics, including TIR (time in range, representing the percentage of time within the range of 4-10 mmol/l for 2 weeks), TAR (time above range), TBR (time below range), mean glucose, standard deviation (SD), and coefficient of variation (CV). Pearson correlation coefficients and linear regression models were utilized for estimation.Results The analysis included 46% women, 30% on insulin pump, 7% with previous coronary heart disease and 64% with retinopathy. Mean +/- SD values were age 48 +/- 18 years, diabetes duration 25 +/- 16 years, HbA1c 58.8 +/- 12.8 mmol/mol, TIR 58.8 +/- 19.0%, TAR 36.3 +/- 20.0%, TBR 4.7 +/- 5.4%, mean sensor glucose 9.2 +/- 2.0 mmol/l, SD 3.3 +/- 1.0 mmol/l, and CV 36 +/- 7%. The overall association between HbA1c and TIR was - 0.71 (Pearson's r), with R 2 0.51 in crude linear regression and 0.57 in an adjusted model. R 2 values between HbA1c and CGM mean glucose were 0.605 (unadjusted) 0.619 (adjusted) and TAR (unadjusted 0.554 and fully adjusted 0.568, respectively), while fully adjusted R 2 values were 0.458, 0.175 and 0.101 between HbA1c and CGM SD, CGM CV and TBR, respectively.Conclusions This descriptive study demonstrates that the degree of association between HbA1c and new and readily available CGM-derived metrics, i.e., time in range (TIR), time above range (TAR), and CGM mean glucose, is robust in assessing the management of individuals with type 1 diabetes in clinical settings. Metrics from CGM that pertain to variability and hypoglycemia exhibit only weak correlations with HbA1c.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Keyword

Type 1 diabetes

Epidemiology

HbA1c

Continuous glucose measurement

Publication and Content Type

ref (subject category)

art (subject category)