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HbA1c, 2-hour glucose equally effective for predicting free-living glycemia
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Free-living glycemia can be predicted equally well by HbA1c and 2-hour glucose testing on continuous glucose monitoring among adolescents with obesity, suggesting both measures are valid for screening for dysglycemia, according to recent study findings published in the Journal of Clinical Endocrinology & Metabolism.
Christine L. Chan, MD, of the department of pediatrics, division of pediatric endocrinology at the University of Colorado Denver, and colleagues evaluated 98 youths aged 10 to 18 years with BMI ≥85th percentile and not on medication for glucose management to determine if HbA1c or the oral glucose tolerance test is a better predictor of free-living glycemia as measured by continuous glucose monitoring (CGM). A blinded CGM was used on all participants for 72 hours, and HbA1c, fasting plasma glucose and 2-hour glucose data were collected.
Christine L. Chan
Median fasting plasma glucose was normal in those with normal HbA1c (83 mg/dL) and prediabetes HbA1c (91 mg/dL) categories. Fasting plasma glucose was ≥90 mg/dL in 36 participants and only nine participants had fasting plasma glucose ≥100 mg/dl. Forty-four participants had prediabetes HbA1c and three had HbA1c ≥6.5%. Two-hour glucose in the prediabetes range was present in 35 participants, and 2-hour glucose ≥200 mg/dL was present in 5 participants.
Compared with participants with normal HbA1c or oral glucose tolerance test results, participants with prediabetes had higher average glucose, area under the curve (AUC), peak glucose and time >120 and >140 mg/dL on CGM.
HbA1c had a greater magnitude of correlation to CGM average glucose, AUC, and minimum glucose, and 2-hour glucose had a greater magnitude of correlation to CGM standard deviation, peak glucose and time >140 and >200 mg/dL. However the strengths of HbA1c and 2-hour glucose correlations to CGM variables were not significantly different. Both HbA1c and 2-hour glucose outperformed fasting plasma glucose in predicting multiple CGM variables.
“HbA1c and oral glucose tolerance testing are equally valid predictors of free-living glucose abnormalities in obese youth,” Chan told Endocrine Today. “For east of collection, these data suggest first-line screening with HbA1c alone is appropriate.”
Disclosure: See the full study for a complete list of the researchers’ relevant financial disclosures.
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