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Cited by 69Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes Management and Education

The relationship between CGM-derived metrics, A1C, and risk of hypoglycemia in older adults with type 1 diabetes

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Toschi, Elena, Slyne, Christine, Sifre, Kayla, O’Donnell, Rachel, Greenberg, Jordan, Atakov-Castillo, Astrid, Carl, Sam, Munshi, Medha·2020·Diabetes Care
DOI 10.2337/dc20-0016PMC PMC7510030
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Abstract

Objective Continuous glucose monitoring (CGM) is now commonly used in the management of type 1 diabetes (T1D). The CGM-derived coefficient of variation (CV) measures glucose variability, and the glucose management indicator (GMI) measures mean glycemia (previously called estimated A1C). However, their relationship with laboratory-measured A1C and the risk of hypoglycemia in older adults with T1D is not well studied. Research design and methods In a single-center study, older adults (age ≥65 years) with T1D wore a CGM device for 14 days. The CV (%) and GMI were calculated, and A1C and clinical and demographic information were collected. Results We evaluated 130 older adults (age 71 ± 5 years), of whom 55% were women, 97% were White, diabetes duration was 39 ± 17 years, and A1C was 7.3 ± 0.6% (56 ± 15 mmol/mol). Participants were stratified by high CV (>36%; n = 77) and low CV (≤36%; n = 53). Although there was no difference in A1C levels between the groups with high and low CV (7.3% [56 mmol/mol] vs. 7.3% [53 mmol/mol], P = 0.4), the high CV group spent more time in hypoglycemia ( P P P = 0.02). Conclusions In older adults with T1D, the use of CGM-derived CV and GMI can better identify individuals at higher risk for hypoglycemia compared with A1C alone. These measures should be combined with A1C for better diabetes management in older adults with T1D.

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  • For older adults with type 1 diabetes, continuous glucose monitoring is a useful approach to predicting and reducing the risk of hypoglycemia.

    “For older adults with type 1 diabetes, continuous glucose monitoring (CGM) is a useful approach to predicting and reducing the risk of hypoglycemia (37).”

    From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [37]

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Authors
Toschi, E., Slyne, C., Sifre, K., O’Donnell, R., Greenberg, J., Atakov-Castillo, A., Carl, S., & Munshi, M.
Affiliations
Joslin Diabetes Center (US)
Corresponding author
Toschi, Elena
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2020-05-27
Volume
43
Issue
10
Pages
2349-2354
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc20-0016
PMC
PMC7510030
OpenAlex
W3030349710
Cited by
69
References
5
Citations by year
2026: 5 · 2025: 11 · 2024: 12 · 2023: 18 · 2022: 8 · 2021: 13 · 2020: 2
FWCI
7.73
Type
journal article
Language
en
Update notices
correction (2021-01-01)
Open access
Licence
www.diabetesjournals.org/content/license (vor, 117 d)
Locations
  • Diabetes Care (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institutes of Health (1DP3-DK-112214-01)
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
continuous glucose monitoring, type 1 diabetes, older adults, hypoglycemia, glycemic variability, coefficient of variation, glucose management indicator, HbA1c, hypoglycemia risk prediction
MeSH terms
Data Accuracy, Glycemic Control, Age Factors, Aged, Aged, 80 and over, Blood Glucose, Data Interpretation, Statistical, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Male, Middle Aged, Risk Factors, Blood Glucose Self-Monitoring, Cohort Studies, Benchmarking

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