Relationship between diurnal glucose levels and HbA1c in type 2 diabetes.

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  • Author(s): Pistrosch F;Pistrosch F; Koehler C; Wildbrett J; Hanefeld M
  • Source:
    Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme [Horm Metab Res] 2006 Jul; Vol. 38 (7), pp. 455-9.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Thieme Country of Publication: Germany NLM ID: 0177722 Publication Model: Print Cited Medium: Print ISSN: 0018-5043 (Print) Linking ISSN: 00185043 NLM ISO Abbreviation: Horm Metab Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: Stuttgart, Thieme.
    • Subject Terms:
      Blood Glucose/*metabolism ; Circadian Rhythm/*physiology ; Diabetes Mellitus, Type 2/*metabolism ; Glycated Hemoglobin/*metabolism; Fasting/metabolism ; Female ; Humans ; Hyperglycemia/metabolism ; Male ; Middle Aged ; Postprandial Period/physiology ; Regression Analysis
    • Abstract:
      Aims and Methods: Study results still conflict on the contribution of diurnal blood glucose (BG) values to Hb (A1c) in type 2 diabetes. We investigated the relationship between Hb (A1c) and diurnal BG obtained under standardized conditions - before breakfast, two hours after breakfast, before lunch, two hours after lunch, before dinner, two hours after dinner, and at 10 PM, 12 midnight and 3 AM in 68 type 2 diabetic patients before and after optimizing glycemic control. The areas under the curve above fasting BG (AUC1) and above 5.6 mmol/l (AUC2) were calculated for further evaluation. Hb (A1c) was measured at baseline and after a mean of 89 (74 to 108) days.
      Results: Each BG value at baseline and after treatment optimization significantly correlated with baseline and follow-up Hb (A1c), respectively. The pre-breakfast BG showed the closest correlation with Hb (A1c). The relative contribution of postprandial BG concentrations (AUC1) to overall hyperglycemia (AUC2) decreased with poorer glycemic control. However, treatment optimization mainly resulted in improved blood glucose values in patients with the poorest glycemic control at baseline. Multiple regression analysis demonstrated that fasting (AUC2-AUC1) and postprandial (AUC1) hyperglycemia independently determined Hb (A1c) or the change in Hb (A1c) after treatment optimization.
      Conclusions: Our findings indicate that intensive blood glucose monitoring during fasting and postprandial states is important for glycemic control, and is therefore an essential part of good clinical practice.
    • Accession Number:
      0 (Blood Glucose)
      0 (Glycated Hemoglobin A)
    • Publication Date:
      Date Created: 20060826 Date Completed: 20061220 Latest Revision: 20221207
    • Publication Date:
      20231215
    • Accession Number:
      10.1055/s-2006-947838
    • Accession Number:
      16933182