Cited by 90Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes Management and Education

The importance of HbA1c and glucose variability in patients with type 1 and type 2 diabetes: outcome of continuous glucose monitoring (CGM)

Sartore, Giovanni, Chilelli, Nino Cristiano, Burlina, Silvia, Stefano, Paola Di, Piarulli, Francesco, Fedele, Domenico, Mosca, Andrea, Lapolla, Annunziata·2012·Acta Diabetologica

Abstract

Glucose variability has recently been investigated in diabetic patients in several studies, but most of them considered only a few variability indicators and did not systematically correlate them with patients' HbA1c levels and other important characteristics. In thus study, the correlations between HbA1c levels and metabolic control (average glucose, AG), glucose variability (SD, CONGA, MAGE, MODD, BG ROC), hyperglycemia (HBGI), hypoglycemia (LBGI) and postprandial (AUC PP) indices were investigated in patients with type 1 and type 2 diabetes. The study involved 68 patients divided into 3 groups as follows: 35 patients had type 1 diabetes (group 1); 17 had type 2 diabetes and were taking multiple daily injections (MDI) of insulin (group 2); and 16 patients had type 2 diabetes treated with OHA and/or basal insulin (group 3). The indicators were obtained over at least 48 h using a continuous glucose monitoring (CGM) system. HbA1c levels were measured at the baseline and after CGM. HbA1c correlated significantly with AG (r = 0.74), AUC PP (r = 0.69) and HBGI (r = 0.74), but only in type 1 diabetic patients. Patients with longstanding disease and type 1 diabetes had a greater glucose variability, irrespective of their HbA1c levels. Insulin therapy with MDI correlated strongly with HbA1c, but not with glucose variability. HbA1c levels identify states of sustained hyperglycemia and seem to be unaffected by hypoglycemic episodes or short-lived glucose spikes, consequently revealing shortcomings as a "gold standard" indicator of metabolic control. Glucose variability indicators describe the glucose profile of type 1 diabetic patients and identify any worsening glycemic control (typical of longstanding diabetes) more accurately than HbA1c tests.

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Crossref · 10.1007/s00592-012-0391-4

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Authors
Sartore, G., Chilelli, N. C., Burlina, S., Stefano, P. D., Piarulli, F., Fedele, D., Mosca, A., & Lapolla, A.
Affiliations
  • University of Padua (IT)
  • Medtronic (Italy) (IT)
  • University of Milan (IT)
Corresponding author
Chilelli, Nino Cristiano
Venue
Acta Diabetologica
Published
2012-04-01
Volume
49
Issue
S1
Pages
153-160
ISSN
  • 0940-5429 (ISSN-L)
  • 1432-5233
OpenAlex
W2010300451
Cited by
90
References
35
Citations by year
2026: 5 · 2025: 10 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 9 · 2020: 10 · 2019: 9 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 13 · 2014: 5 · 2013: 8 · 2012: 6
FWCI
8.14
Type
journal article
Language
en
Open access
closed
Locations
  • Acta Diabetologica (publishedVersion)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
HbA1c, glycemic variability, type 1 diabetes, type 2 diabetes, continuous glucose monitoring, glycemic control, multiple daily insulin injections, basal insulin, oral antidiabetic drugs, hypoglycemia, hyperglycemia, postprandial blood glucose, disease duration
MeSH terms
Adult, Aged, Blood Glucose, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Insulin, Male, Middle Aged, Treatment Outcome, Drug Monitoring, Young Adult

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