Endocrine Journal
Online ISSN : 1348-4540
Print ISSN : 0918-8959
ISSN-L : 0918-8959
ORIGINAL
Evaluation of the relationship between glycated hemoglobin A1c and mean glucose levels derived from the professional continuous flash glucose monitoring system
Masanobu Yamada, Shuichi Okada, Hiroki Oda, Yasuyo Nakajima, Claire C. Bastie, Yuko Kasai, Aya Osaki, Yoko Shimoda, Ryo Shibusawa, Ryota Uehara, Tsugumichi Saito, Atsushi Ozawa, Eijiro Yamada
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Keywords: Average glucose, Continuous glucose monitoring (CGM), Diabetes, FreeStyle Libre Pro©, HbA1c
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2020 Volume 67 Issue 5 Pages 531-536

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Abstract

Previously, we reported that short-term continuous glucose monitoring (CGM) with the professional iPro2© CGM device is a good clinical indicator of glycated hemoglobin (HbA1c) levels. However, there was no significant correlation between CGM and HbA1c levels when HbA1c levels were >8.0%. To further investigate this issue, we performed a similar study using the FreeStyle Libre Pro©, a newer device that does not require glucose calibration and allows patients to be examined for up to 14 days. Fifty-nine patients (68% women, 32% men) were examined. Twenty-eight and 31 patients presented with type 1 and type 2 diabetes, respectively. Clinically assessed HbA1c levels were compared to blood glucose levels determined by the FreeStyle Libre Pro© for up to 14 days (10.7 ± 3.7 days). We found a significant correlation between HbA1c and CGM levels even when HbA1c levels were >8.0%. Additionally, the correlation between HbA1c and average glucose was identified with the modern CGM and was found to deviate substantially from the new suggested formula. More importantly, we found a more robust correlation between HbA1c and CGM levels in patients with type 2 diabetes. Overestimation or underestimation of blood glucose levels through CGM might increase the risks of inappropriate clinical treatment of diabetes patients. Our results indicate the need for proper CGM data interpretation individualized for each patient to better assist the determination of customized treatments for patients.

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