Erna Lenters-Westra, Marion Fokkert, Eric S Kilpatrick, Erwin Schleicher, Scott Pilla, Emma English, Peter van Dijk
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In this article, we present a checklist of potential sources of error for both GMI and HbA<sub>1c</sub> values and provide suggestions to mitigate these sources in order to continue to improve diabetes care.</p><p><strong>Methods: </strong>We identified key literature pertaining to GMI measurement, HbA<sub>1c</sub> measurement, and potential factors of discordance between the two. Using these sources, we explore the potential factors leading to discordance and how to mitigate these when found.</p><p><strong>Results: </strong>We have constructed a quick reference checklist covering the main sources of discordance between HbA<sub>1c</sub> and GMI, with accompanying narrative text for more detailed discussion. Discordance can arise due to various factors, including CGM accuracy, sensor calibration, red blood cell turnover and other physiological conditions.</p><p><strong>Conclusions: </strong>GMI will likely continue to be used in the upcoming years by both persons with diabetes and their health care providers, and so it is important for users of CGM devices to be equipped with the knowledge to understand the potential causes of discordance between GMI and HbA<sub>1c</sub> values.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70023"},"PeriodicalIF":3.2000,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Managing discordance between HbA<sub>1c</sub> and glucose management indicator.\",\"authors\":\"Erna Lenters-Westra, Marion Fokkert, Eric S Kilpatrick, Erwin Schleicher, Scott Pilla, Emma English, Peter van Dijk\",\"doi\":\"10.1111/dme.70023\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>The assessment of haemoglobin A1c (HbA<sub>1c</sub>) continues to play an essential role in diabetes care; however, major advances in new technologies widen the armament available to clinicians to further refine treatment for their patients. Whilst HbA<sub>1c</sub> remains a critical glycaemic marker, advances in technologies such as Continuous Glucose Monitoring (CGM) now offer real-time glucose monitoring, allowing a more instant assessment of glycaemic control. Discrepancies between laboratory-measured HbA<sub>1c</sub> and Glucose Management Indicator (GMI) values are a significant clinical issue. In this article, we present a checklist of potential sources of error for both GMI and HbA<sub>1c</sub> values and provide suggestions to mitigate these sources in order to continue to improve diabetes care.</p><p><strong>Methods: </strong>We identified key literature pertaining to GMI measurement, HbA<sub>1c</sub> measurement, and potential factors of discordance between the two. Using these sources, we explore the potential factors leading to discordance and how to mitigate these when found.</p><p><strong>Results: </strong>We have constructed a quick reference checklist covering the main sources of discordance between HbA<sub>1c</sub> and GMI, with accompanying narrative text for more detailed discussion. Discordance can arise due to various factors, including CGM accuracy, sensor calibration, red blood cell turnover and other physiological conditions.</p><p><strong>Conclusions: </strong>GMI will likely continue to be used in the upcoming years by both persons with diabetes and their health care providers, and so it is important for users of CGM devices to be equipped with the knowledge to understand the potential causes of discordance between GMI and HbA<sub>1c</sub> values.</p>\",\"PeriodicalId\":11251,\"journal\":{\"name\":\"Diabetic Medicine\",\"volume\":\" \",\"pages\":\"e70023\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-03-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetic Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/dme.70023\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetic Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dme.70023","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Managing discordance between HbA1c and glucose management indicator.
Aims: The assessment of haemoglobin A1c (HbA1c) continues to play an essential role in diabetes care; however, major advances in new technologies widen the armament available to clinicians to further refine treatment for their patients. Whilst HbA1c remains a critical glycaemic marker, advances in technologies such as Continuous Glucose Monitoring (CGM) now offer real-time glucose monitoring, allowing a more instant assessment of glycaemic control. Discrepancies between laboratory-measured HbA1c and Glucose Management Indicator (GMI) values are a significant clinical issue. In this article, we present a checklist of potential sources of error for both GMI and HbA1c values and provide suggestions to mitigate these sources in order to continue to improve diabetes care.
Methods: We identified key literature pertaining to GMI measurement, HbA1c measurement, and potential factors of discordance between the two. Using these sources, we explore the potential factors leading to discordance and how to mitigate these when found.
Results: We have constructed a quick reference checklist covering the main sources of discordance between HbA1c and GMI, with accompanying narrative text for more detailed discussion. Discordance can arise due to various factors, including CGM accuracy, sensor calibration, red blood cell turnover and other physiological conditions.
Conclusions: GMI will likely continue to be used in the upcoming years by both persons with diabetes and their health care providers, and so it is important for users of CGM devices to be equipped with the knowledge to understand the potential causes of discordance between GMI and HbA1c values.
期刊介绍：
Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions.
The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed.
We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services.
Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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