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What Is the Role of A1C in Comorbidities

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The ADAG Study Group defined the relationship between average blood glucose (AG) and A1C. They derived an equation valid across diabetes types but excluded comorbidities known to impact A1C. The… Click to show full abstract

The ADAG Study Group defined the relationship between average blood glucose (AG) and A1C. They derived an equation valid across diabetes types but excluded comorbidities known to impact A1C. The goal of this study is to examine the relationship between AG and A1C in patients omitted from prior analyses. A retrospective chart review was performed of downloaded glucose data from patients prescribed insulin at the UW Diabetes Center between 1/2011-10/2017. Patients were identified who had either 1) documentation and/or laboratory confirmation of anemia; 2) CKD; or 3) NAFLD. Eligible charts required: 1) 2 weeks of fingerstick glucose (SMBG) data with ≥14 checks or 1 month of CGM with ≥14 complete days and, 2) an A1C measured within 1 month of the encounter. The SMBG and CGM means were obtained from downloads. An AG was extrapolated from the A1c using the ADAG equation. The downloaded data and A1C-derived AGs were compared. There was a linear correlation between AG and A1C (R2=0.48) in anemic patients regardless of etiology. Non-anemic patients (N=220) had better ADAG agreement (70% of AGs inside 15% of predicted) than anemic patients (55% of AGs, N=123, p=0.006). Normal GFR yielded 71% of AGs inside 15% of ADAG estimation (N=440). This decreased to 59% if limited to anemic patients (N=83, p Disclosure J.E. Perlman: None. J.L. Rosenbaum: None. B.K. McNulty: None. I.B. Hirsch: Research Support; Self; Medtronic MiniMed, Inc.. Consultant; Self; Abbott, Bigfoot Biomedical, Roche Diabetes Care Health and Digital Solutions, ADOCIA.

Keywords: etiology; a1c; a1c comorbidities; anemic patients; none; role a1c

Journal Title: Diabetes
Year Published: 2018

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