title: New indices for predicting glycaemic variability.
abstract: Blood glucose variability is known to be associated with increased risk of long-term complications. Reliable indices for predicting hyperglycaemic and hypoglycaemic fluctuations are therefore needed. Glycaemic standard deviation (SD) obtained by continuous glucose monitoring correlates closely with nine previously described glycaemic variability formulas. Here, new indices predictive of glycaemic variability were developed, which can be calculated from laboratory measures based on a single blood draw. The indices included the glycated albumin (GA) to HbA1c ratio (GA/A1c ratio) and the fasting C-peptide immunoreactivity (FCPR) to fasting plasma glucose (FPG) ratio (FCPR index). Predictive values of these indices were assessed in 100 adults with diabetes. GA/A1c ratio and FCPR index showed close associations with glycaemic SD in addition to the nine existing glucose variability formulas. Subjects with a GA/A1c ratio ≥ 2.8 and FCPR index <3.0 showed the greatest SD and longest durations of hypoglycaemia, while those with a GA/A1c ratio <2.8 and FCPR index ≥ 3.0 had smaller SDs and little sign of hypoglycaemia. In adults with diabetes, a high GA/A1c ratio and low FCPR index value reflect higher glycaemic excursions, irrespective of diabetes type. Simultaneous measurements of GA, HbA1c, FPG and FCPR may help to identify a group of patients who warrant closer monitoring in relation to glycaemic variability and hypoglycaemia.
authors.affiliation: Department of Endocrinology, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Akifumi
authors.initials: A
authors.lastname: Ogawa
authors.forename: Akinori
authors.initials: A
authors.lastname: Hayashi
authors.forename: Eriko
authors.initials: E
authors.lastname: Kishihara
authors.forename: Sonomi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Akihiro
authors.initials: A
authors.lastname: Takeuchi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Shichiri
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose; D002096:C-Peptide / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood*; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D017127:Glycation End Products, Advanced; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D012016:Reference Values; D012709:Serum Albumin / Q000378:metabolism; D000093423:Glycated Serum Albumin
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human