PDF(Pubmed)
Abstract：
The introduction of continuous glucose monitoring (CGM) systems in clinical practice has allowed a more detailed picture of the intra- and interdaily glycemic fluctuations of individuals with type 1 diabetes (T1D). However, CGM-measured glucose control indicators may be occasionally inaccurate. This study aims to assess the discrepancy between the glucose management indicator (GMI) and glycated hemoglobin (HbA1c) (ΔGMI-HbA1c) within a cohort of children and adolescents with T1D, exploring its correlation with other CGM metrics and blood count parameters. In this single-center, cross-sectional study, we gathered demographic and clinical data, including blood count parameters, HbA1c values, and CGM metrics, from 128 pediatric subjects with T1D (43% female; mean age, 13.4 ± 3.6 years). Our findings revealed higher levels of the coefficient of variation (CV) (p < 0.001) and time above range > 250 mg/dL (p = 0.033) among subjects with ΔGMI-HbA1c > 0.3%. No association was observed between blood count parameters and ΔGMI-HbA1c. In conclusion, despite the advancements and the widespread adoption of CGM systems, HbA1c remains an essential parameter for the assessment of glycemic control, especially in individuals with suboptimal metabolic control and extreme glycemic variability.
摘要：
在临床实践中引入连续葡萄糖监测（CGM）系统可以更详细地了解1型糖尿病（T1D）患者的每日和每日血糖波动。然而,CGM测量的葡萄糖控制指标有时可能不准确。这项研究旨在评估T1D儿童和青少年队列中葡萄糖管理指标（GMI）和糖化血红蛋白（HbA1c）（ΔGMI-HbA1c）之间的差异。探讨其与其他CGM指标和血细胞计数参数的相关性。在这个单一中心，横断面研究，我们收集了人口统计学和临床数据，包括血细胞计数参数,HbA1c值,和CGM指标，来自128名患有T1D的儿科受试者(43%为女性；平均年龄，13.4±3.6年）。我们的发现显示，在ΔGMI-HbA1c>0.3％的受试者中，变异系数（CV）（p<0.001）和超过250mg/dL（p=0.033）的时间较高。在血细胞计数参数和ΔGMI-HbA1c之间没有观察到相关性。总之,尽管CGM系统取得了进步和广泛采用，HbA1c仍然是评估血糖控制的重要参数，特别是在代谢控制欠佳和血糖变异性极高的个体中。
