Yongjin Xu1, Yushi Hirota2, Ramzi A Ajjan3, Akane Yamamoto2, Atsuko Matsuoka2, Wataru Ogawa2, Timothy C Dunn1. 1. Abbott Diabetes Care, Alameda, CA, USA. 2. Division of Diabetes and endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan. 3. Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Abstract
BACKGROUND: A recent kinetic model proposed a new individualized glycaemic marker, calculated HbA1c (cHbA1c), based on kinetic parameters and glucose levels that are specific to each person. The aims of the current work were to validate the accuracy of this glucose metric for clinical use and evaluate data requirements for the estimation of personal kinetic factors. METHODS: We retrieved HbA1c and glucose data from a group of 51 Japanese T1D patients under sensor-augmented pump (SAP) therapy. Two patient-specific kinetic parameters were identified by data sections, defined as continuous glucose data between two laboratory HbA1c measurements. The cHbA1c was prospectively validated employing subsequent HbA1c data that were not originally used to determine personal kinetic parameters. RESULTS: Compared to estimated HbA1c (eHbA1c) and glucose management indicator (GMI), cHbA1c showed clinically relevant accuracy improvement, with 20% or more within ±0.5% (±5.5 mmol/mol) of laboratory HbA1c. The mean absolute deviation of the cHbA1c calculation was 0.11% (1.2 mmol/mol), substantially less than for eHbA1c and GMI at 0.54% (5.9 mmol/mol) and 0.47% (5.1 mmol/mol), respectively. CONCLUSION: Our study shows superior performance of cHbA1c compared with eHbA1c and GMI at reflecting laboratory HbA1c, making it a credible glucose metric for routine clinical use.
BACKGROUND: A recent kinetic model proposed a new individualized glycaemic marker, calculated HbA1c (cHbA1c), based on kinetic parameters and glucose levels that are specific to each person. The aims of the current work were to validate the accuracy of this glucose metric for clinical use and evaluate data requirements for the estimation of personal kinetic factors. METHODS: We retrieved HbA1c and glucose data from a group of 51 Japanese T1D patients under sensor-augmented pump (SAP) therapy. Two patient-specific kinetic parameters were identified by data sections, defined as continuous glucose data between two laboratory HbA1c measurements. The cHbA1c was prospectively validated employing subsequent HbA1c data that were not originally used to determine personal kinetic parameters. RESULTS: Compared to estimated HbA1c (eHbA1c) and glucose management indicator (GMI), cHbA1c showed clinically relevant accuracy improvement, with 20% or more within ±0.5% (±5.5 mmol/mol) of laboratory HbA1c. The mean absolute deviation of the cHbA1c calculation was 0.11% (1.2 mmol/mol), substantially less than for eHbA1c and GMI at 0.54% (5.9 mmol/mol) and 0.47% (5.1 mmol/mol), respectively. CONCLUSION: Our study shows superior performance of cHbA1c compared with eHbA1c and GMI at reflecting laboratory HbA1c, making it a credible glucose metric for routine clinical use.
Entities:
Keywords:
Glycated hemoglobin; continuous glucose monitoring; kinetic modeling; red blood cell glucose uptake; red blood cell lifespan; red blood cell turnover
Authors: Matthew D Campbell; Daniel J West; Lauren L O'Mahoney; Sam Pearson; Noppadol Kietsiriroje; Mel Holmes; Ramzi A Ajjan Journal: J Diabetes Metab Disord Date: 2022-03-31
Authors: Yongjin Xu; Richard M Bergenstal; Timothy C Dunn; Yashesvini Ram; Ramzi A Ajjan Journal: Diabetes Obes Metab Date: 2022-06-02 Impact factor: 6.408