Relative contributions of preprandial and postprandial glucose exposures, glycemic variability, and non-glycemic factors to HbA 1c in individuals with and without diabetes

• DOI: 10.1038/s41387-018-0047-8
• Publication Date: 2018-05-30T16:50:00Z
• Authors: Kristine Færch; Marjan Alssema; David J. Mela; Rikke Borg; Dorte Vistisen
• Keywords: Adult; Blood Glucose; Glycated Hemoglobin; Male; 2. Zero hunger; Blood Glucose Self-Monitoring; Fasting; Middle Aged; Postprandial Period; Article; 03 medical and health sciences; Glucose; 0302 clinical medicine; Diabetes Mellitus, Type 2; Humans; Female; Aged

There is substantial interest in dietary approaches to reducing postprandial glucose (PPG) responses, but the quantitative contribution of PPG longer-term glycemic control (reflected glycated hemoglobin, HbA1c) general population not known. This study quantified associations preprandial exposure, and variability with HbA1c estimated explained variance individuals without type 2 diabetes (T2D).Participants A1c-Derived Average Glucose (ADAG) T2D (n = 77) or non-insulin-treated HbA1c<6.5% (T2DHbA1c < 6.5%, n 63) ≥ 6.5% 34) were included this analysis. Indices glucose, PPG, calculated from continuous monitoring during four periods over 12 weeks prior measurement. In linear regression models, we exposures proportion by non-glycemic factors (age, sex, body mass index, ethnicity).The analysis 35% non-diabetic individuals, 49% T2DHbA1c 78% 6.5%. exposure was associated confounder-adjusted analyses (P 0.05). group, all measures 0.05); accounted for 14 18%, respectively, variation. these more than 50% variation equal relative contributions.Among exposures, most strongly predictive suggesting that interventions targeting lowering response may be beneficial long-term maintenance. T2D, contributed equally HbA1c.