Abstract
Glycated haemoglobin (HbA1c) is the golden standard in the assessment of long-term diabetes control. It has certain flaws and can be misleading especially in chronic kidney disease, anaemia and other RBC disturbances.
The growing use of continuous glucose sensors has enabled the assessment of diabetes control by the glucose management indicator (GMI) based on average glycemia and thus glycation only. In certain patients, GMI differs significantly from HbA1c, which reflects both glycation and deglycation processes together.
This difference is characterised by the haemoglobin glycation index (HGI). HGI = HbA1c - GMI.
The higher HGI observed in patients is associated with higher glycaemic variability and greater incidence of diabetic complications. This association suggests the harmful role of increased glycation in the pathogenesis of diabetic vascular changes.
Patients with high HGI could profit out of individually adjusted and stricter glycaemic targets.