ArticleInternational journal of medical sciences2026
Associations of Hemoglobin Glycation Index with Glucose Variability and Time in Ranges in Patients with Type 2 Diabetes Undergoing Continuous Glucose Monitoring.
Article in International journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Discordance between glycated hemoglobin (HbA1c) levels and blood glucose is commonly observed in clinical practice. The hemoglobin glycation index (HGI) has been proposed as a measure to quantify individual variations in glycation. Our study aimed to investigate the association between HGI and glucose variability assessed by continuous glucose monitoring (CGM) in patients with type 2 diabetes (T2D) treated with metformin monotherapy. Methods: Adults with T2D treated with metformin monotherapy (daily dose ≥ 1500 mg) who had HbA1c levels ≥ 7.0% (n = 100; mean age 54.0 ± 8.2 years; 52.0% female) undergoing CGM were analyzed. Predicted HbA1c was derived from linear regression of HbA1c on fasting plasma glucose, and the HGI was calculated as observed HbA1c minus predicted HbA1c. CGM metrics-including standard deviation, coefficient of variation, mean amplitude of glycemic excursions (MAGE), and time in ranges-were analyzed to evaluate their associations with HGI. Results: HGI was significantly associated with mean sensor glucose (β = 13.60, 95% CI 5.16-22.04, p = 0.002) and CGM-derived glucose variability metrics, including standard deviation (β = 7.53, 95% CI 4.49-10.58, p < 0.001), coefficient of variation (β = 2.22, 95% CI 0.29-4.15, p = 0.025), and MAGE (β = 22.14, 95% CI 14.59-29.69, p < 0.001). These associations remained significant after multivariable adjustment. HGI was also negatively associated with time in range (β = -7.29, 95% CI -12.79 to -1.79, p = 0.010) and positively associated with time above range (β = 7.35, 95% CI 1.69-13.01, p = 0.011). Conclusion: These findings highlight a significant association between HGI and glucose variability from CGM, suggesting that HGI may serve as a complementary marker in diabetes management.
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