Associations between features of glucose exposure and A1C: the A1C-Derived Average Glucose (ADAG) study
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Associations between features of glucose exposure and A1C : the A1C-Derived Average Glucose (ADAG) study. / ADAG Study Group.
I: Diabetes, Bind 59, Nr. 7, 07.2010, s. 1585-90.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Associations between features of glucose exposure and A1C
T2 - the A1C-Derived Average Glucose (ADAG) study
AU - Borg, Rikke
AU - Kuenen, Judith C
AU - Carstensen, Bendix
AU - Zheng, Hui
AU - Nathan, David M
AU - Heine, Robert J
AU - Nerup, Jorn
AU - Borch-Johnsen, Knut
AU - Witte, Daniel R
AU - ADAG Study Group
PY - 2010/7
Y1 - 2010/7
N2 - OBJECTIVE: Various methods are used to quantify postprandial glycemia or glucose variability, but few have been compared and none are standardized. Our objective was to examine the relationship among common indexes of postprandial glycemia, overall hyperglycemia, glucose variability, and A1C using detailed glucose measures obtained during everyday life and to study which blood glucose values of the day provide the strongest prediction of A1C.RESEARCH DESIGN AND METHODS: In the A1C-Derived Average Glucose (ADAG) study, glucose levels were monitored in 507 participants (268 type 1 diabetic, 159 type 2 diabetic, and 80 nondiabetic subjects) with continuous glucose monitoring (CGM) and frequent self-monitoring of blood glucose (SMBG) during 16 weeks. We calculated several indexes of glycemia and analyzed their intercorrelations. The association between glucose measurements at different times of the day (pre- and postprandial) and A1C was examined using multiple linear regression.RESULTS: Indexes of glucose variability showed strong intercorrelation. Among postprandial indexes, the area under the glucose curve calculated from CGM 2 h after a meal correlated well with the 90-min SMBG postprandial measurements. Fasting blood glucose (FBG) levels were only moderately correlated with indexes of hyperglycemia and average or postprandial glucose levels. Indexes derived with SMBG strongly correlated with those from CGM. Some SMBG time points had a stronger association with A1C than others. Overall, preprandial glucose values had a stronger association with A1C than postprandial values for both diabetes types, particularly for type 2 diabetes.CONCLUSIONS: Indexes of glucose variability and average and postprandial glycemia intercorrelate strongly within each category. Variability indexes are weakly correlated with the other categories, indicating that these measures convey different information. FBG is not a clear indicator of general glycemia. Preprandial glucose values have a larger impact on A1C levels than postprandial values.
AB - OBJECTIVE: Various methods are used to quantify postprandial glycemia or glucose variability, but few have been compared and none are standardized. Our objective was to examine the relationship among common indexes of postprandial glycemia, overall hyperglycemia, glucose variability, and A1C using detailed glucose measures obtained during everyday life and to study which blood glucose values of the day provide the strongest prediction of A1C.RESEARCH DESIGN AND METHODS: In the A1C-Derived Average Glucose (ADAG) study, glucose levels were monitored in 507 participants (268 type 1 diabetic, 159 type 2 diabetic, and 80 nondiabetic subjects) with continuous glucose monitoring (CGM) and frequent self-monitoring of blood glucose (SMBG) during 16 weeks. We calculated several indexes of glycemia and analyzed their intercorrelations. The association between glucose measurements at different times of the day (pre- and postprandial) and A1C was examined using multiple linear regression.RESULTS: Indexes of glucose variability showed strong intercorrelation. Among postprandial indexes, the area under the glucose curve calculated from CGM 2 h after a meal correlated well with the 90-min SMBG postprandial measurements. Fasting blood glucose (FBG) levels were only moderately correlated with indexes of hyperglycemia and average or postprandial glucose levels. Indexes derived with SMBG strongly correlated with those from CGM. Some SMBG time points had a stronger association with A1C than others. Overall, preprandial glucose values had a stronger association with A1C than postprandial values for both diabetes types, particularly for type 2 diabetes.CONCLUSIONS: Indexes of glucose variability and average and postprandial glycemia intercorrelate strongly within each category. Variability indexes are weakly correlated with the other categories, indicating that these measures convey different information. FBG is not a clear indicator of general glycemia. Preprandial glucose values have a larger impact on A1C levels than postprandial values.
KW - Adolescent
KW - Adult
KW - Aged
KW - Blood Glucose/metabolism
KW - Blood Glucose Self-Monitoring
KW - Diabetes Mellitus, Type 1/blood
KW - Diabetes Mellitus, Type 2/blood
KW - Female
KW - Glycated Hemoglobin A/metabolism
KW - Humans
KW - Hyperglycemia/blood
KW - Male
KW - Middle Aged
KW - Monitoring, Ambulatory
KW - Postprandial Period/physiology
KW - Regression Analysis
U2 - 10.2337/db09-1774
DO - 10.2337/db09-1774
M3 - Journal article
C2 - 20424232
VL - 59
SP - 1585
EP - 1590
JO - Diabetes
JF - Diabetes
SN - 0012-1797
IS - 7
ER -
ID: 203775502