Glucose Management Indicator (GMI): A New Term for Estimating A1C From Continuous Glucose Monitoring.
Glucose Management Indicator (GMI): A New Term for Estimating A1C From Continuous Glucose Monitoring.
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DOI：
10.2337/dc18-1581
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发表时间：
2018-11
期刊：
影响因子：
16.2
通讯作者：
Cefalu WT
中科院分区：
文献类型：
--
作者：
Bergenstal RM;Beck RW;Close KL;Grunberger G;Sacks DB;Kowalski A;Brown AS;Heinemann L;Aleppo G;Ryan DB;Riddlesworth TD;Cefalu WT
虽然糖化血红蛋白已被公认为糖尿病并发症的重要风险标志，但随着持续血糖监测（CGM）的使用越来越多，以帮助安全有效地管理糖尿病，了解CGM指标（如平均血糖）与糖化血红蛋白之间的关系非常重要。估计糖化血红蛋白（eA1C）是一种将平均血糖从CGM或自我监测的血糖读数转换成同时测量的实验室糖化血红蛋白的测量方法，使用从个体群体的血糖读数导出的公式。许多患者和临床医生认为eA1C是一个有用的教育工具，但如果eA1C和实验室测量的A1C不一致，其他人往往会感到困惑甚至沮丧。在美国，食品和药物管理局认为eA1C的命名需要改变。这促使作者致力于多部分解决方案，以促进这一指标的保留，其中包括将eA1C重命名为葡萄糖管理指标（GMI），并基于最近使用最准确的CGM系统的临床试验，生成一个将CGM导出的平均葡萄糖转换为GMI的新公式。确保从旧的eA1C到新的GMI的顺利过渡的最后一个方面是提供新的CGM分析和解释，以进一步了解如何解释GMI并在临床实践中最有效地使用它。本观点将阐述为什么需要一个新的eA1C名称，为什么选择GMI作为新名称，GMI是如何计算的，以及如果选择将GMI作为糖尿病教育或管理的工具，如何理解和解释GMI。
While A1C is well established as an important risk marker for diabetes complications, with the increasing use of continuous glucose monitoring (CGM) to help facilitate safe and effective diabetes management, it is important to understand how CGM metrics, such as mean glucose, and A1C correlate. Estimated A1C (eA1C) is a measure converting the mean glucose from CGM or self-monitored blood glucose readings, using a formula derived from glucose readings from a population of individuals, into an estimate of a simultaneously measured laboratory A1C. Many patients and clinicians find the eA1C to be a helpful educational tool, but others are often confused or even frustrated if the eA1C and laboratory-measured A1C do not agree. In the U.S., the Food and Drug Administration determined that the nomenclature of eA1C needed to change. This led the authors to work toward a multipart solution to facilitate the retention of such a metric, which includes renaming the eA1C the glucose management indicator (GMI) and generating a new formula for converting CGM-derived mean glucose to GMI based on recent clinical trials using the most accurate CGM systems available. The final aspect of ensuring a smooth transition from the old eA1C to the new GMI is providing new CGM analyses and explanations to further understand how to interpret GMI and use it most effectively in clinical practice. This Perspective will address why a new name for eA1C was needed, why GMI was selected as the new name, how GMI is calculated, and how to understand and explain GMI if one chooses to use GMI as a tool in diabetes education or management.
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影响因子：
16.2
作者：
Danne T;Nimri R;Battelino T;Bergenstal RM;Close KL;DeVries JH;Garg S;Heinemann L;Hirsch I;Amiel SA;Beck R;Bosi E;Buckingham B;Cobelli C;Dassau E;Doyle FJ 3rd;Heller S;Hovorka R;Jia W;Jones T;Kordonouri O;Kovatchev B;Kowalski A;Laffel L;Maahs D;Murphy HR;Nørgaard K;Parkin CG;Renard E;Saboo B;Scharf M;Tamborlane WV;Weinzimer SA;Phillip M
通讯作者：
Phillip M
影响因子：
16.2
作者：
通讯作者：
--
影响因子：
4.2
作者：
Fonseca, Vivian A.;Grunberger, George;Tamborlane, William
通讯作者：
Tamborlane, William
影响因子：
16.2
作者：
Wilson, Darrell M.;Xing, Dongyuan;Tamborlane, William V.
通讯作者：
Tamborlane, William V.
影响因子：
168.9
作者：
Heinemann, Lutz;Freckmann, Guido;Hermanns, Norbert
通讯作者：
Hermanns, Norbert