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| Title |
Validation of a hemoglobin A1c model in patients with type 1 and type 2 diabetes and its use to go beyond the averaged relationship of hemoglobin A1c and mean glucose level
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|---|---|
| Published in |
Journal of Translational Medicine, December 2014
|
| DOI | 10.1186/s12967-014-0328-5 |
| Pubmed ID | |
| Authors |
Piotr Ladyzynski, Piotr Foltynski, Marianna I Bak, Stanislawa Sabalinska, Janusz Krzymien, Jerzy Kawiak |
| Abstract |
BackgroundGlycated hemoglobin A1c (HbA1c) has been used as an index of glycemic control in the management, guidance, and clinical trials of diabetic patients for the past 35 years. The aim of this study was to validate the HbA1c model in patients with type 1 and type 2 diabetes and to use it to support interpretation of HbA1c in different clinical situations.MethodsThe HbA1c model was identified in 30 patients (15 with type 1 diabetes and 15 with type 2 diabetes) by estimating the overall glycation rate constant (k), based on results of continuous glucose monitoring. The model was validated by assessing its ability to predict HbA1c changes in cultures of erythrocytes in vitro and to reproduce results of the A1C-Derived Average Glucose (ADAG) study. The model was used to simulate the influence of different glucose profiles on HbA1c.ResultsThe mean k was equal to 1.296¿±¿0.216¿×¿10¿9 l mmol¿1 s¿1 with no difference between type 1 and type 2 diabetes. The mean coefficient of variation of k was equal to 16.7%. The model predicted HbA1c levels in vitro with a mean absolute difference less than 0.3% (3.3 mmol/mol). It reproduced the linear relationship of HbA1c established in the ADAG study. The simulation experiments demonstrated that during periods of unstable glycemic control, glycemic profiles with the same mean glucose might result in much different HbA1c levels.ConclusionsPatients with type 1 and type 2 diabetes are characterized by the same mean value of k, but there is considerable interindividual variation in the relationship of HbA1c and mean glucose level. Results suggest that reciprocal changes in glycation rate and the life span of erythrocytes exist in a wide range of HbA1c values. Thus, for an average patient with diabetes, no modifications of parameters of the glycation model are required to obtain meaningful HbA1c predictions. Interpreting HbA1c as a measure of the mean glucose is fully justified only in the case of stable glycemia. The model and more frequent tests of HbA1c might be used to decrease ambiguity of interpreting HbA1c in terms of glycemic control. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 38 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 38 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 7 | 18% |
| Student > Master | 5 | 13% |
| Student > Ph. D. Student | 4 | 11% |
| Other | 3 | 8% |
| Student > Bachelor | 3 | 8% |
| Other | 5 | 13% |
| Unknown | 11 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 42% |
| Nursing and Health Professions | 4 | 11% |
| Engineering | 3 | 8% |
| Agricultural and Biological Sciences | 2 | 5% |
| Unknown | 13 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 December 2014.
All research outputs
#20,246,428
of 22,774,233 outputs
Outputs from Journal of Translational Medicine
#3,307
of 3,984 outputs
Outputs of similar age
#302,542
of 361,208 outputs
Outputs of similar age from Journal of Translational Medicine
#89
of 123 outputs
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We're also able to compare this research output to 123 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.