Metrics to Evaluate Quality of Glycemic Control: Comparison of Time in Target, Hypoglycemic, and Hyperglycemic Ranges with "Risk Indices".

Abstract:

OBJECTIVE:We sought to cross validate several metrics for quality of glycemic control, hypoglycemia, and hyperglycemia. RESEARCH DESIGN AND METHODS:We analyzed the mathematical properties of several metrics for overall glycemic control, and for hypo- and hyperglycemia, to evaluate their similarities, differences, and interrelationships. We used linear regression to describe interrelationships and examined correlations between metrics within three conceptual groups. RESULTS:There were consistently high correlations between %Time in range (%TIR) and previously described risk indices (M100, Blood Glucose Risk Index [BGRI], Glycemic Risk Assessment Diabetes Equation [GRADE], Index of Glycemic Control [IGC]), and with J-Index (J). There were also high correlations among %Hypoglycemia, Low Blood Glucose Index (LBGI), percentage of GRADE attributable to hypoglycemia (GRADE%Hypoglycemia), and Hypoglycemia Index, but negligible correlation with J. There were high correlations of percentage of time in hyperglycemic range (%Hyperglycemia) with High Blood Glucose Index (HBGI), percentage of GRADE attributable to hyperglycemia (GRADE%Hyperglycemia), Hyperglycemia Index, and J. %TIR is highly negatively correlated with %Hyperglycemia but very weakly correlated with %Hypoglycemia. By adjusting the parameters used in IGC, Hypoglycemia Index, Hyperglycemia Index, or in MR, one can more closely approximate the properties of BGRI, LBGI, or HBGI, and of GRADE, GRADE%Hypoglycemia, or GRADE%Hyperglycemia. CONCLUSIONS:Simple readily understandable criteria such as %TIR, %Hypoglycemia, and %Hyperglycemia are highly correlated with and appear to be as informative as "risk indices." The J-Index is sensitive to hyperglycemia but insensitive to hypoglycemia.

journal_name

Diabetes Technol Ther

authors

Rodbard D

doi

10.1089/dia.2017.0416

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

325-334

issue

5

eissn

1520-9156

issn

1557-8593

journal_volume

20

pub_type

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