Usefulness of CGM-Derived Metric, the Glucose Management Indicator, to Assess Glycemic Control in Non-White Individuals With Diabetes

Toschi, Elena; Michals, Amy; Adam, Atif; Davis, Dai’Quann J.; Atakov-Castillo, Astrid; Slyne, Christine; Munshi, Medha

doi:10.2337/dc21-1373

Cited by 13 publications

(5 citation statements)

References 13 publications

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“…Larger studies about differences in measures of glycemia, including continuous glucose monitoring, by race and ethnicity in pregnancy are needed. 44 In addition, trials that identify which interventions, including mobile applications and care models that integrate social determinants of health, may be most effective in decreasing disparities in glycemic control are needed.…”

Section: Discussionmentioning

confidence: 99%

Differences in Hemoglobin A1c during Pregnancy between Non-Hispanic Black versus White Women with Prepregnancy Diabetes

et al. 2022

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Objective:To determine whether change in HbA1c from early to late pregnancy differs between non-Hispanic Black and White women with prepregnancy diabetes. Study design:A retrospective analysis from an integrated prenatal and diabetes care program from 2012-2016. We compared HbA1c as a continuous measure, and secondarily, HbA1c<6.5%, cross-sectionally and longitudinally in early (~10 weeks) and late (~31 weeks) pregnancy. Linear and logistic regression were used, and adjusted for age, body mass index, White diabetes class, pharmacotherapy, diabetes type, gestational age at baseline HbA1c measurement, and baseline hemoglobin. Results:Among 296 non-Hispanic Black (35%) and White pregnant women (65%) with prepregnancy diabetes (39% type 1, 61% type 2), Black women were more likely experience increased social determinants of health as measured by the Social Vulnerability Index (SVI), and were less likely to have type 1 diabetes and have more severe diabetes versus White women (p<0.05). Black women had higher mean HbA1c (7.8 vs. 7.4%; Beta: 0.75;95%CI: 0.30 to 1.19), and were less likely to have a HbA1c<6.5% at 10 weeks compared to White women (24 vs. 35%;AOR:0.45;95%CI: 0.24 to 0.81); but not after adjusting for SVI. At 31 weeks, both groups had similar mean HbA1c (both 6.5%) and were equally as likely to have a HbA1c<6.5% (57 vs. 54%). From early to late pregnancy, Black women had a higher percentage decrease in HbA1c (1.3% vs. 0.9%;Beta=0.63; 95%CI: 0.27 to 0.99), and were equally as likely to have an improvement or stable HbA1C <6.5% from 10 to 31 weeks, with both groups having a similar mean HbA1c (6.5%) at 31 weeks. Conclusion:Despite experiencing greater community-level social determinants of health, Black women with pregestational diabetes had a larger reduction in HbA1c and were able to equally achieve target HbA1c<6.5% by late pregnancy compared to White women as part of an integrated diabetes and prenatal care prog

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Section: Discussionmentioning

confidence: 99%

Differences in Hemoglobin A1c during Pregnancy between Non-Hispanic Black versus White Women with Prepregnancy Diabetes

et al. 2022

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“…The number of GMIs was introduced to address discrepancies between laboratory HbA1c and estimated HbA1c values using the mean glucose values obtained from CGM [19,20]. In 641 individuals with mostly type 1 diabetes, 50% and 22% had a discordance between the number of GMIs and HbA1c of > 0.5% and > 1%, respectively [21].…”

Section: Summary Of Glucose Metrics According To Prediabetes Subgroupsmentioning

confidence: 99%

Continuous glucose monitoring indicators according to heterogeneity of prediabetes: The Kangbuk Samsung Health Study

Choi

Jang

Chang

2023

Preprint

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Introduction: A prediabetes diagnosis is based on composite criteria, although the heterogeneity among the prediabetes diagnostic criteria is not fully understood. We investigated the different characteristics of continuous glucose monitoring (CGM) indicators in prediabetes defined by different diagnostic criteria. Methods: We included 969 participants without diabetes from the Kangbuk Samsung Total Healthcare Center who underwent CGM as part of a comprehensive health examination from January–December 2021. The participants were categorized into following four groups: healthy, isolated glucose prediabetes, isolated HbA1c prediabetes, and prediabetes meeting the respective criteria (fasting blood glucose [FBG] and glycated hemoglobin [HbA1c] levels of < 100 mg/dL and < 5.7%; 100–125 mg/dL and < 5.7%; < 100 mg/dL and 5.7─6.4%, respectively). CGM metrics were measured using a glucose monitor. Results: Themean FBG levels of the isolated glucose prediabetes, isolated HbA1c prediabetes, and prediabetes meeting both the FBG and HbA1c criteria groups were 105.0 ± 4.7, 93.4 ± 4.6, and 107.9 ± 6.4, respectively; the corresponding HbA1c levels were 5.5 ± 0.1, 5.8 ± 0.1, and 5.9 ± 0.2, respectively. The mean glucose levels were 106.1 ± 10.0, 105.0 ± 10.8, and 111.9 ± 10.6, respectively; the mean numbers of glucose management indicators (GMIs) were 5.8 ± 0.2, 5.8 ± 0.3, and 6.0 ± 0.3, respectively. Conclusion: Between the isolated glucose and HbA1c prediabetes groups, the differences in mean blood glucose and GMIs measured by CGM were attenuated compared with FBG and HbA1c levels. These results may help to better our understanding of prediabetes pathophysiology.

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“…From a clinical perspective, the potential discordance between GMI and HbA1c could help inform diabetes management 74 . For instance, a greater difference between HbA1c and GMI was associated with higher risk of hypoglycaemia in a non‐White population 75 …”

Section: Cgmmentioning

confidence: 99%

“… 74 For instance, a greater difference between HbA1c and GMI was associated with higher risk of hypoglycaemia in a non‐White population. 75 …”

Section: Cgmmentioning

confidence: 99%

Clinical application guidelines for blood glucose monitoring in China (2022 edition)

Bao

Zhu

2022

Diabetes Metabolism Res

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Glucose monitoring is an important component of diabetes management. The Chinese Diabetes Society (CDS) has been producing evidence-based guidelines on the optimal use of glucose monitoring since 2011. In recent years, new technologies in glucose monitoring and more clinical evidence, especially those derived from Chinese populations, have emerged. In this context, the CDS organised experts to revise the Clinical application guidelines for blood glucose monitoring in China in 2021. In this guideline, we focus on four methods of glucose monitoring that are commonly used in clinical practice, including capillary glucose monitoring, glycated haemoglobin A1c, glycated albumin, and continuous glucose monitoring. We describe the definitions and technical characteristics of these methods, the factor that may interfere with the measurement, the advantages and caveats in clinical practice, the interpretation of glucose metrics, and the relevant supporting evidence. The recommendations for the use of these methods are also provided. The various methods of glucose monitoring have their strengths and limitations and cannot be replaced by one another. We hope that these guidelines could aid in the optimal application of common methods of glucose monitoring in clinical practice for better diabetes care. K E Y W O R D S diabetes, glucose monitoring, guideline 1 | INTRODUCTION Glucose monitoring, as an important part of diabetes management, serves to evaluate the glucose status and the effectiveness of glucose lowering therapies. Common methods of glucose monitoring that are used in clinical practice include capillary glucose monitoring (which includes self-monitoring of blood glucose [SMBG] and the point-ofcare testing [POCT] in hospital), glycated haemoglobin A1c (HbA1c), glycated albumin (GA), and continuous glucose monitoring (CGM). In 2011, the Chinese Diabetes Society (CDS) issued the Clinical application guideline for blood glucose monitoring in China ( 2011Edition) (hereinafter referred to as the guideline), and further revision was made in 2015. In recent years, glucose monitoring technology is evolving in a more convenient, accurate, and minimally invasive or even noninvasive direction. In order to further standardise the use of various tools based on the recent advancements in technologies and evidence, the guideline is revised and updated again.The guideline lists the recommendations at the beginning of each chapter and marks the level of evidence (Table 1). Evidence level A is the evidence based on multiple randomised controlled trials or metaanalysis; evidence level B is the evidence based on a single randomised controlled trial or multiple non-randomised controlled trials;This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Usefulness of CGM-Derived Metric, the Glucose Management Indicator, to Assess Glycemic Control in Non-White Individuals With Diabetes

Cited by 13 publications

References 13 publications

Differences in Hemoglobin A1c during Pregnancy between Non-Hispanic Black versus White Women with Prepregnancy Diabetes

Differences in Hemoglobin A1c during Pregnancy between Non-Hispanic Black versus White Women with Prepregnancy Diabetes

Continuous glucose monitoring indicators according to heterogeneity of prediabetes: The Kangbuk Samsung Health Study

Clinical application guidelines for blood glucose monitoring in China (2022 edition)

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