title: The interrelationship of HbA1c and real-time continuous glucose monitoring in children with type 1 diabetes.
abstract: OBJECTIVE
  The aim of this observational study is to investigate the relationship between age, duration of diabetes, HbA1c and the parameters of glucose levels measured with real-time CGM in children with type 1 diabetes.
  
  
  METHODS
  Glucose level was characterized with the relative time spent in hyper- and hypoglycemia, central tendency, variability and MAGE during (real-time) CGM. These parameters were measured in 57 children with type 1 diabetes mellitus. The univariate association of the measured parameters was investigated with scatterplots as well as with linear and distance correlation coefficients.
  
  
  RESULTS
  Age and duration of diabetes were not clinically relevantly associated with any descriptor of glucose level. HbA1c had an overall positive association with variability and MAGE observed during CGM. Slight, but non-significant, positive association of HbA1c was observed with the time spent in hyperglycemia and the central tendency of glucose level. With the exception of MAGE, the associations of the descriptors with HbA1c are non-monotonic, with a temporary break in the positive correlation at 10%.
  
  
  CONCLUSIONS
  The results confirmed the well-known positive association of HbA1c with the central tendency of glucose level. The non-monotonic relationship between HbA1c and the indicators of the central tendency of glucose level might be caused by the changed adherence of the patients during the period of CGM. HbA1c's positive association with MAGE without non-monotonicity underlines MAGE's usefulness in the reliable assessment of the patients' glycemic state.
authors: Óbuda University, John von Neumann Faculty of Informatics, Physiological Controls Group, Bécsi út 96/b, H-1034 Budapest, Hungary. Electronic address: ferenci.tamas@nik.uni-obuda.hu.
authors: Tamás
authors: T
authors: Ferenci
authors: Semmelweis University, 1st Department of Paediatrics, Bókay János u. 53-54, H-1083 Budapest, Hungary. Electronic address: korner.anna@med.semmelweis-univ.hu.
authors: Anna
authors: A
authors: Körner
authors: Óbuda University, John von Neumann Faculty of Informatics, Physiological Controls Group, Bécsi út 96/b, H-1034 Budapest, Hungary. Electronic address: kovacs.levente@nik.uni-obuda.hu.
authors: Levente
authors: L
authors: Kovács
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Continuous glucose monitoring; Glucose variability; Hawthorne effect; HbA1c; Pediatric type 1 diabetes mellitus