JEAN-PIERRE RIVELINE, GAETAN PREVOST, ANAIS ANDRIEU, MICHAEL JOUBERT, PHILIPPE ORIOT, ALFRED PENFORNIS, JEAN-CHRISTOPHE PHILIPS, JEAN-BAPTISTE JULLA, EMMANUEL COSSON
{"title":"1020-P: Evolution over Time of the Discrepancy between HbA1c and Glucose Management Indicator—Findings from a Franco-Belgian Cohort of 347 Patients","authors":"JEAN-PIERRE RIVELINE, GAETAN PREVOST, ANAIS ANDRIEU, MICHAEL JOUBERT, PHILIPPE ORIOT, ALFRED PENFORNIS, JEAN-CHRISTOPHE PHILIPS, JEAN-BAPTISTE JULLA, EMMANUEL COSSON","doi":"10.2337/db24-1020-p","DOIUrl":null,"url":null,"abstract":"A discrepancy between laboratory-measured HbA1c and Glucose Management Indicator (GMI), estimated from continuous glucose monitoring, is frequently encountered in clinical practice. However, its evolution over time is not yet known. Methodology: We conducted a multicenter retrospective study (9 centers) that collected pairs of HbA1c and GMI (calculated over 90 days) at T0, T1 year, T2 years of follow-up in patients with diabetes, all users of FreeStyleLibre®. The primary study endpoint was the analysis of the mean HbA1c-GMI differences at the 3 time points. Glucose data, clinical parameters, and complications were also analyzed. Patients were classified based on the HbA1c-GMI discrepancy: positive (PosD, HbA1c-GMI>+0.3%), neutral (NullD, HbA1c-GMI from -0.3 to +0.3%), negative (NegD, HbA1c-GMI< -0.3%) at each time point, and with the average differences over the 3 time points. Group comparisons were assessed using ANOVA. Result: We included 347 patients (82% type 1 diabetes), mean age of 51±17 years, diabetes duration 20±13 years, HbA1c 7.6±1.0%, 90±9% CGM data collected, Time in Range 70-180 mg/dl (TIR) 57±17%, GMI 7.4±0.8%. The mean HbA1c-GMI differed over time (T0: 0.27%, T1 year: 0.16%, T2 years: 0.04%, P<0.0001). Considering the mean HbA1c-GMI differences over the 3 time points for all patients, PosD individuals were statistically older, had higher BMI and HbA1c compared to NegD patients. At T0, the patients were distributed as follows: 168 PosD (48.4%), 129 NullD (37.2%), 50 NegD (14.4%). The 121 patients (only 34.8% of the cohort) who stayed in the same group at the three time-points were 44.6% PosD, 38% NullD and 17.4% NegD. Conclusion: In only 1/3 of patients does the difference between HbA1c and GMI appear to be stable over time. This should be taken into account when analyzing the supposed poor prognosis associated with PosD. Disclosure J. Riveline: Board Member; Abbott, Novo Nordisk A/S, Sanofi, Eli Lilly and Company, Medtronic, Dexcom, Inc., Insulet Corporation, Air Liquide, AstraZeneca. G. Prevost: Board Member; Abbott. A. Andrieu: None. M. Joubert: Consultant; Abbott, Medtronic, Dexcom, Inc. P. Oriot: Research Support; Abbott. A. Penfornis: Speaker's Bureau; Sanofi, Dexcom, Inc., Diabeloop SA. Board Member; AstraZeneca. Speaker's Bureau; Novo Nordisk, Lilly Diabetes. Board Member; Novo Nordisk, Bayer Inc. Advisory Panel; Abbott, Sanofi. J. Philips: Consultant; Sanofi, Novo Nordisk, Abbott, Avazzia, Boehringer-Ingelheim, Eli Lilly and Company. J. Julla: Speaker's Bureau; Lilly Diabetes, Novo Nordisk. Board Member; Sanofi. E. Cosson: Advisory Panel; Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk, Sanofi, Roche Diagnostics, Novartis AG, Amgen Inc. Funding Abbott Diabetes Care","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":null,"pages":null},"PeriodicalIF":6.2000,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2337/db24-1020-p","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
A discrepancy between laboratory-measured HbA1c and Glucose Management Indicator (GMI), estimated from continuous glucose monitoring, is frequently encountered in clinical practice. However, its evolution over time is not yet known. Methodology: We conducted a multicenter retrospective study (9 centers) that collected pairs of HbA1c and GMI (calculated over 90 days) at T0, T1 year, T2 years of follow-up in patients with diabetes, all users of FreeStyleLibre®. The primary study endpoint was the analysis of the mean HbA1c-GMI differences at the 3 time points. Glucose data, clinical parameters, and complications were also analyzed. Patients were classified based on the HbA1c-GMI discrepancy: positive (PosD, HbA1c-GMI>+0.3%), neutral (NullD, HbA1c-GMI from -0.3 to +0.3%), negative (NegD, HbA1c-GMI< -0.3%) at each time point, and with the average differences over the 3 time points. Group comparisons were assessed using ANOVA. Result: We included 347 patients (82% type 1 diabetes), mean age of 51±17 years, diabetes duration 20±13 years, HbA1c 7.6±1.0%, 90±9% CGM data collected, Time in Range 70-180 mg/dl (TIR) 57±17%, GMI 7.4±0.8%. The mean HbA1c-GMI differed over time (T0: 0.27%, T1 year: 0.16%, T2 years: 0.04%, P<0.0001). Considering the mean HbA1c-GMI differences over the 3 time points for all patients, PosD individuals were statistically older, had higher BMI and HbA1c compared to NegD patients. At T0, the patients were distributed as follows: 168 PosD (48.4%), 129 NullD (37.2%), 50 NegD (14.4%). The 121 patients (only 34.8% of the cohort) who stayed in the same group at the three time-points were 44.6% PosD, 38% NullD and 17.4% NegD. Conclusion: In only 1/3 of patients does the difference between HbA1c and GMI appear to be stable over time. This should be taken into account when analyzing the supposed poor prognosis associated with PosD. Disclosure J. Riveline: Board Member; Abbott, Novo Nordisk A/S, Sanofi, Eli Lilly and Company, Medtronic, Dexcom, Inc., Insulet Corporation, Air Liquide, AstraZeneca. G. Prevost: Board Member; Abbott. A. Andrieu: None. M. Joubert: Consultant; Abbott, Medtronic, Dexcom, Inc. P. Oriot: Research Support; Abbott. A. Penfornis: Speaker's Bureau; Sanofi, Dexcom, Inc., Diabeloop SA. Board Member; AstraZeneca. Speaker's Bureau; Novo Nordisk, Lilly Diabetes. Board Member; Novo Nordisk, Bayer Inc. Advisory Panel; Abbott, Sanofi. J. Philips: Consultant; Sanofi, Novo Nordisk, Abbott, Avazzia, Boehringer-Ingelheim, Eli Lilly and Company. J. Julla: Speaker's Bureau; Lilly Diabetes, Novo Nordisk. Board Member; Sanofi. E. Cosson: Advisory Panel; Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk, Sanofi, Roche Diagnostics, Novartis AG, Amgen Inc. Funding Abbott Diabetes Care
期刊介绍:
Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes.
However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.