Discordance between mean glucose and time in range in relation to HbA1c in individuals with type 1 diabetes: results from the GOLD and SILVER trials

• DOI: 10.1007/s00125-024-06151-2
• Publication Date: 2024-04-26T11:01:38Z
• Authors: Sofia Sterner Isa...; Henrik Imberg; Irl B. Hirsch; Erik Schwarcz; Jarl Hellman; Magnus Wijkman; Jan Bolinder; Thomas Nyström; Helene Holmer; Sara Hallström; Arndís F. Ólafsdó...; Sofia Pekkari; William Polonsky; Marcus Lind
• Keywords: Human physiology

Abstract Aims/hypothesis Previous studies have shown that individuals with similar mean glucose levels (MG) or percentage of time in range (TIR) may different HbA 1c values. The aim this study was to further elucidate how MG and TIR are associated . Methods Data from the randomised clinical GOLD trial ( n =144) follow-up SILVER =98) adults type 1 diabetes followed for 2.5 years were analysed. A total 596 paired /continuous monitoring measurements included. Linear mixed-effects models used account intra-individual correlations repeated-measures data. Results In trial, age participants (± SD) 44±13 years, 63 (44%) female, 72±9.8 mmol/mol (8.7±0.9%). When correlating , explained 63% variation r =0.79, p <0.001). by increased 88% =0.94, value improvement fit <0.001) when accounting person-to-person MG–HbA relationship. Time below (TBR; <3.9 mmol/l), above (TAR) level 2 (>13.9 mmol/l) glycaemic variability had little no effect on association. For a given TIR, 10% deviated >8 (0.8%) their estimated based overall association between TBR TAR significantly influenced At each 1% increase related 0.6 lower (95% CI 0.4, 0.9; <0.001), 2% 0.4 higher 0.1, 0.6; =0.003). However, neither nor MG. Conclusions/interpretation Inter-individual variations exist as well clinically important deviations relatively large groups diabetes. These results provide information both healthcare providers terms prognosis making management decisions. Graphical