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Translating Glycated Hemoglobin A1c into Time Spent in Glucose Target Range: a Multicenter Study
School of Medical Sciences, Örebro University, Örebro, Sweden.
Department of Pediatrics, Ryhov County Hospital, Jönköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Örebro University, School of Medical Sciences. Department of Pediatrics, University Hospital Örebro, Örebro, Sweden.ORCID iD: 0000-0002-1440-9961
2019 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 20, no 3, p. 339-344Article in journal (Refereed) Published
Abstract [en]

Background: Approximately 90% of children and adolescents with type 1 diabetes in Sweden use continuous glucose monitoring (CGM), either as real-time CGM or intermittently scanned CGM to monitor their glucose levels. Time in target range (TIT) is an easily understandable metric for assessing glycemic control.

Objective: The aim of this study was to examine the relation between TIT and hemoglobin A1c (HbA1c).

Subjects and Methods: Subjects were recruited from three diabetes care centers in Sweden. Glucose data were collected for 133 children and adolescents with type 1 diabetes through CGM using Diasend. Subjects with registration time over 80% were included in the analysis. HbA1c was collected from SWEDIABKIDS, the Swedish pediatric diabetes quality registry. TIT was defined as 3.9 to 7.8 mmol/L (70-140 mg/dL) and time in range (TIR) as 3.9 to 10 mmol/L (70-180 mg/dL).

Results: During the period of 60 days, 105 subjects provided complete data for analysis. Mean age was 12.2 (±3.3) years, mean HbA1c was 53.9 (±8.2) mmol/mol or 7.1% (±0.7%). Mean sensor glucose value was 8.6 (±1.3) mmol/L, mean coefficient of variation was 42.2% (±7.2%), mean TIT was 40.9% (±SD 12.2%), and mean TIR was 60.8% (±13.1%). There was a significant nonlinear relation between TIT during 60 days and HbA1c, R 2 = 0.69.

Conclusion: This study suggests a nonlinear relation between time spent in glucose target range and HbA1c. The finding implies that time spent in TIT could be a useful metric in addition to HbA1c to assess glycemic control.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019. Vol. 20, no 3, p. 339-344
Keywords [en]
HbA1c, Type 1 diabetes, children, continuous glucose monitoring, time in target range
National Category
Endocrinology and Diabetes Pediatrics
Identifiers
URN: urn:nbn:se:oru:diva-71655DOI: 10.1111/pedi.12817ISI: 000464382400013PubMedID: 30652407Scopus ID: 2-s2.0-85060846136OAI: oai:DiVA.org:oru-71655DiVA, id: diva2:1281406
Funder
Swedish Diabetes AssociationAvailable from: 2019-01-22 Created: 2019-01-22 Last updated: 2019-06-18Bibliographically approved

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Särnblad, Stefan

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