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Continuous Glucose Monitoring and Use of Alternative Markers To Assess Glycemia in Chronic Kidney Disease
- Source :
- Diabetes Care
- Publication Year :
- 2020
-
Abstract
- OBJECTIVE In chronic kidney disease, glycated albumin and fructosamine have been postulated to be better biomarkers of glycemic control than HbA1c. We evaluated the accuracy, variability, and covariate bias of three biomarkers (HbA1c, glycated albumin, and fructosamine) compared with continuous glucose monitoring (CGM)–derived measurement of glycemia across estimated glomerular filtration rate (eGFR) in type 2 diabetes. RESEARCH DESIGN AND METHODS A prospective cohort study was conducted of 104 participants with type 2 diabetes, 80 with eGFR RESULTS Within-person biomarker values were strongly correlated between the two CGM periods (r = 0.92–0.95), although no marker fully captured the within-person variability of mean CGM glucose. All markers were similarly correlated with mean CGM glucose (r = 0.71–77). Compared with mean CGM glucose, glycated albumin and fructosamine were significantly biased by age, BMI, serum iron concentration, transferrin saturation, and albuminuria; HbA1c was underestimated in those with albuminuria. CONCLUSIONS Glycated albumin and fructosamine were not less variable than HbA1c at a given mean CGM glucose level, with several additional sources of bias. These results support measuring HbA1c to monitor trends in glycemia among patients with eGFR
- Subjects :
- Blood Glucose
Glycation End Products, Advanced
Male
medicine.medical_specialty
endocrine system diseases
Endocrinology, Diabetes and Metabolism
Renal function
030209 endocrinology & metabolism
Type 2 diabetes
Gastroenterology
Cohort Studies
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
Diabetes mellitus
Internal Medicine
Medicine
Humans
Glycated Serum Albumin
030212 general & internal medicine
Renal Insufficiency, Chronic
Serum Albumin
Glycemic
Aged
Advanced and Specialized Nursing
Glycated Hemoglobin
business.industry
Transferrin saturation
Blood Glucose Self-Monitoring
Clinical Care/Education/Nutrition/Psychosocial Research
nutritional and metabolic diseases
Middle Aged
medicine.disease
Fructosamine
chemistry
Diabetes Mellitus, Type 2
Case-Control Studies
Albuminuria
Female
medicine.symptom
business
Biomarkers
Kidney disease
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 19355548
- Volume :
- 43
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Diabetes care
- Accession number :
- edsair.doi.dedup.....78487402dddad5c212e726ab6be47f70