A.Manov, Y. Badi, A.Donepudi, N.Holt, E. Dini, R. Rivera, B. Gieler, R. Haddadin, I. Quadir, K. Mefferd

Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada 

 *Prof. Andre Manov, MD ,Transitional Year Residency Program Director

Abstract:

We conducted a retrospective observational cohort study between 2020-2023in 26patients with type-1 and type-2 Diabetes Mellitus (DM) who were using 3-4 injections per day of Insulinand were monitored by continuous glucose monitoring (CGM). The goal was to compare the patient’s glycosylated hemoglobin (HbA1c) taken during their clinic visit by phlebotomy as a marker for diabetic control with estimated HbA1c glucose management indicator (GMI) derived from the 30-day CGM readings. Both parameters were taken within 30-days of each other. We excluded patients with known anemia, chronic kidney disease, polycythemia, cirrhosis of the liver, or metabolic dysfunction associated with steatohepatitis (MASH) because these disease states can affect the measured HbA1c. Also, pregnant and African American patients were excluded, because they can have changes in their HbA1c based on the pregnancy and race. We concluded the measured HbA1c was 0.34% higher than the CGM-derived GMI. The relationship between those factors of glycemic control was discussed in the article as well as the future utilization of them in improving diabetic control and management. As the use of CGM continues to grow, addressing differences between laboratory-measured HbA1c and CGM-derived GMI is critical. The purpose of this retrospective observational cohort study is to compare these two metrics in an internal medicine community primary care residency clinic.

Key Words:

Glucose management Indicator(GMI), HbA1c, Insulin, Continuous Glucose monitoring(CGM),Restrospective study