Relationship between hemoglobin glycation index and risk of hypoglycemia in type 2 diabetes with time-in-range in target

doi:10.4239/wjd.v15.i10.2058

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Diabetes. Oct 15, 2024; 15(10): 2058-2069
Published online Oct 15, 2024. doi: 10.4239/wjd.v15.i10.2058

Table 1 Clinical characteristics of study participants

Characteristic	Total	HGI < 0.5	HGI ≥ 0.5	P value
Participants, n (%)	129	72 (56)	57 (44)
Age (years), mean ± SD	54.84 ± 12.56	53.33 ± 12.28	56.75 ± 12.75	0.414
Female	70 (54)	35 (49)	35 (61)	0.148
BMI (kg/m²)	24.52 ± 3.11	24.33 ± 12.14	24.76 ± 6.62	0.392
Duration of diabetes (months), medians (IQR)	73 (109.5)	73 (85.17)	97.33 (127.77)	0.287
Diabetes therapy, n (%)
Diet only	25 (19)	18 (25)	7 (12)	0.077
Sulfonylurea	21 (16)	11 (15)	10 (18)	0.812
Metformin	58 (45)	27 (38)	31 (54)	0.075
α-glucosidase inhibitor	33 (26)	18 (25)	15 (26)	0.865
DPP4 inhibitor	28 (22)	18 (25)	10 (18)	0.391
SGLT-2 inhibitor	5 (4)	3 (4)	2 (4)	0.848
CSII/MDI	35 (27)	15 (21)	20 (35)	0.071
SBP (mmHg), mean ± SD	127.35 ± 14.09	126.22 ± 13.51	128.77 ± 14.79	0.375
DBP (mmHg), mean ± SD	80.84 ± 9.19	79.79 ± 8.06	82.18 ± 10.37	0.104
TC (mmol/L), mean ± SD	4.39 ± 1.07	4.33 ± 1.02	4.46 ± 1.13	0.790
TG (mmol/L), mean ± SD	1.63 ± 1.26	1.63 ± 1.48	1.64 ± 0.93	0.285
LDL-C (mmol/L), mean ± SD	2.68 ± 0.89	2.60 ± 0.86	2.78 ± 0.92	0.275
HDL-C (mmol/L), mean ± SD	1.13 ± 0.48	1.19 ± 0.58	1.07 ± 0.30	0.216
Laboratory HbA1c (%), mean ± SD	6.63 ± 1.27	5.95 ± 0.71	7.43 ± 1.30	< 0.001^a
Hemoglobin (g/L), mean ± SD	133.84 ± 14.68	136.33 ± 13.21	131.70 ± 15.92	0.085
Hemotocrit (%), mean ± SD	0.40 ± 0.04	0.41 ± 0.04	0.39 ± 0.05	0.042^a
Red cell distribution width (%), mean ± SD	0.13 ± 0.01	0.13 ± 0.01	0.13 ± 0.01	0.556
Hypoglycemia, n (%)	49	10 (14)	39 (67)	< 0.001^a

^aP < 0.05, compared with the values from two groups.

HGI: Hemoglobin glycation index; BMI: Body mass index; DPP4: Dipeptidyl peptidase-4; SGLT-2: Sodium-glucose co-transporter type 2; CSII: Continuous subcutaneous insulin infusion; MDI: Multiple daily injection; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; TC: Total cholesterol; TG: Triglyceride; LDL-C: Low density lipoprotein cholesterol; HDL-C: High density lipoprotein cholesterol; HbA1c: Hemoglobin A1c; IQR: Interquartile range.

Table 2 Continuous glucose monitoring parameters

Characteristic	Total	HGI < 0.5	HGI ≥ 0.5	P value
Participants, n (%)	129	72 (56)	57 (44)
GMI (%), mean ± SD	6.09 ± 0.67	6.11 ± 0.70	6.06 ± 0.63	0.752
Average glucose (mmol/L), mean ± SD	7.11 ± 1.06	7.13 ± 1.10	7.08 ± 1.02	0.885
SDBG (mmol/L), mean ± SD	1.67 ± 0.64	1.59 ± 0.63	1.77 ± 0.64	0.961
CV (%), mean ± SD	22.89 ± 7.65	21.41 ± 6.78	24.76 ± 8.31	0.017^a
MAGE (mmol/L), mean ± SD	4.08 ± 1.81	3.88 ± 1.72	4.35 ± 1.91	0.742
LAGE (mmol/L), mean ± SD	8.86 ± 3.03	8.26 ± 2.89	9.63 ± 3.06	0.005^a
MODD (mmol/L), medians (IQR)	1.40 (0.70)	1.30 (0.50)	1.50 (0.60)	0.024^a
TIR (% of time 39-10 mmol/L), medians (IQR)	90 (17)	93.50 (13)	86 (16)	0.002^a
TBR (% of time < 3.9 mmol/L), medians (IQR)	1 (5)	0 (2)	2 (11)	< 0.001^a
TAR (% of time > 10 mmol/L), medians (IQR)	6 (13)	4.50 (11)	8 (12)	0.068

^aP < 0.05, compared with the values from two groups.

HGI: Hemoglobin glycation index; GMI: Glucose management indicator; SDBG: Standard deviation blood glucose; CV: Coefficient of variation; MAGE: Mean amplitude of glucose excursion; LAGE: Largest amplitude of glycemic excursions; MODD: Mean of daily differences; TIR: Time in range; TBR: Time below range; TAR: Time above range.

Table 3 Clinical markers of glycemia variables for hypoglycemia analyzed by univariate and multiple logistic regression analyses

	Univariate logistic regression			Multiple logistic regression
	χ²	P value	OR (95%CI)	Wald χ²	P value	OR (95%CI)
Sex (female/male)	0.82	0.37	0.73 (0.36-1.45)
Age	4.25	0.04^a	0.42 (0.19-0.96)
BMI	0.09	0.77	1.11 (0.55-2.25)
Laboratory HbA1c	0.36	0.55	0.81 (0.41-1.62)
Hemotocrit	1.81	0.18	1.75 (0.78-3.95)
MBG	4.26	0.04^a	0.45 (0.21-0.96)	9.05	< 0.01^a	0.17 (0.05-0.54)
SDBG	9.74	< 0.01^a	3.44 (1.58-7.47)	5.30	0.02^a	5.37 (1.28-22.46)
LAGE	3.41	0.07	7.56 (0.88-64.67)
MAGE	6.95	0.01^a	2.62 (1.28-5.35)
MODD	0.32	0.57	1.36 (0.46-4.01)
HGI	6.98	< 0.01^a	2.65 (1.29-5.44)	4.65	0.03^a	2.46 (1.09-5.58)
Use of insulin and/or sulfonylurea	0.30	0.58	1.22 (0.60-2.51)

^aP < 0.05.

OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; HbA1c: Hemoglobin A1c; MBG: Mean blood glucose; SDBG: Standard deviation blood glucose; LAGE: LAGE: Largest amplitude of glycemic excursions; MAGE: Mean amplitude of glucose excursion; MODD: Mean of daily differences; HGI: Hemoglobin glycation index.

Citation: Lin BS, Liu ZG, Chen DR, Yang YL, Yang DZ, Yan JH, Zeng LY, Yang XB, Xu W. Relationship between hemoglobin glycation index and risk of hypoglycemia in type 2 diabetes with time-in-range in target. World J Diabetes 2024; 15(10): 2058-2069
URL: https://www.wjgnet.com/1948-9358/full/v15/i10/2058.htm
DOI: https://dx.doi.org/10.4239/wjd.v15.i10.2058