| Title: |
Association between the GMI/HbA1c ratio and preclinical carotid atherosclerosis in type 1 diabetes: impact of the fast-glycator phenotype across age groups. |
| Authors: |
Puig-Jové, Carlos1 (AUTHOR) cpuig@mutuaterrassa.cat, Viñals, Clara2,3 (AUTHOR) vinals@clinic.cat, Conget, Ignacio2,3 (AUTHOR) iconget@clinic.cat, Quirós, Carmen1 (AUTHOR) cquiros@mutuaterrassa.cat, Vinagre, Irene2,3 (AUTHOR) ivinagre@clinic.cat, Berrocal, Belén1 (AUTHOR) bberrocal@mutuaterrassa.cat, Blanco-Carrasco, Antonio-Jesús2,3 (AUTHOR) ablanco@clinic.cat, Granados, Montserrat2 (AUTHOR) mgranad1@clinic.cat, Mesa, Alex2,4 (AUTHOR) almepi@gmail.com, Serés-Noriega, Tonet2 (AUTHOR) tseresnoriega@gmail.com, Giménez, Marga2,3 (AUTHOR) gimenez@clinic.cat, Perea, Verónica1 (AUTHOR) vperea@mutuaterrassa.cat, Amor, Antonio J.2,3 (AUTHOR) ajamor@clinic.cat |
| Source: |
Cardiovascular Diabetology. 2/15/2025, Vol. 24 Issue 1, p1-12. 12p. |
| Subject Terms: |
*CONTINUOUS glucose monitoring, *TYPE 1 diabetes, *CAROTID intima-media thickness, *CAROTID artery ultrasonography, *MEDICAL sciences |
| Abstract: |
Background: Since the arrival of continuous glucose monitoring (CGM), the relationship between the glucose management indicator (GMI) and HbA1c has been a topic of considerable interest in diabetes research. This study aims to explore the association between the GMI/HbA1c ratio and the presence of preclinical carotid atherosclerosis in type 1 diabetes (T1D). Methods: Individuals with T1D and no prior history of cardiovascular disease were recruited from two centers. Carotid ultrasonography was performed using a standardized protocol and carotid plaques were defined as intima-media thickness ≥ 1.5 mm. CGM-derived data were collected from a 14-day report. A GMI/HbA1c ratio < 0.90 was selected to identify "fast-glycator" phenotype. Results: A total of 584 participants were included (319 women, 54.6%), with a mean age of 48.8 ± 10.7 years and a mean diabetes duration of 27.5 ± 11.4 years. Carotid plaques were present in 231 subjects (39.6%). Approximately 43.7% and 13.4% of participants showed absolute differences of ≥ 0.5 and ≥ 1.0 between 14-day GMI and HbA1c, respectively. Among patients ≥ 48 years, the fast-glycator phenotype was independently associated with presence of plaques (OR 2.27, 95%CI: 1.06–4.87), even after adjusting for non-specific and T1D-specific risk factors and statin treatment. No significant association was observed in younger subjects (p for interaction < 0.05). Conclusions: Fast-glycator phenotype is independently associated with atherosclerosis in T1D individuals aged ≥ 48 years, suggesting an age-related increase in the glycation risk. These findings highlight the potential of the GMI/HbA1c ratio for cardiovascular risk stratification in this population. [ABSTRACT FROM AUTHOR] |
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