Laboratory HbA_1c does not always predict diabetes complications and our aim was to establish a glycaemic measure that better reflects intracellular glucose exposure in organs susceptible to complications. Six months of continuous glucose monitoring data and concurrent laboratory HbA_1c were evaluated from 51 type 1 diabetes (T1D) and 80 type 2 diabetes (T2D) patients. Red blood cell (RBC) lifespan was estimated using a kinetic model of glucose and HbA_1c, allowing the calculation of person-specific adjusted HbA_1c (aHbA_1c). Median (IQR) RBC lifespan was 100 (86–102) and 100 (83–101) days in T1D and T2D, respectively. The median (IQR) absolute difference between aHbA_1c and laboratory HbA_1c was 3.9 (3.0–14.3) mmol/mol [0.4 (0.3–1.3%)] in T1D and 5.3 (4.1–22.5) mmol/mol [0.5 (0.4–2.0%)] in T2D. aHbA_1c and laboratory HbA_1c showed clinically relevant differences. This suggests that the widely used measurement of HbA_1c can underestimate or overestimate diabetes complication risks, which may have future clinical implications.

中文翻译：

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使用包含红细胞寿命的模型解决实验室 HbA1c 的不足

实验室 HbA _1c并不总能预测糖尿病并发症，我们的目标是建立一种血糖测量值，以更好地反映易受并发症影响器官的细胞内葡萄糖暴露。从 51 名 1 型糖尿病 (T1D) 和 80 名 2 型糖尿病 (T2D) 患者中评估了六个月的连续血糖监测数据和同步实验室 HbA _1c。使用葡萄糖和 HbA _1c的动力学模型估计红细胞 (RBC) 寿命，允许计算特定人的调整后的 HbA _1c (aHbA _1c )。T1D 和 T2D 的中值 (IQR) RBC 寿命分别为 100 (86-102) 和 100 (83-101) 天。aHbA _1c之间的中位数 (IQR) 绝对差实验室 HbA _1c在 T1D 中为 3.9 (3.0-14.3) mmol/mol [0.4 (0.3-1.3%)]，在 T2D 中为 5.3 (4.1-22.5) mmol/mol [0.5 (0.4-2.0%)]。aHbA _1c和实验室 HbA _1c显示出临床相关的差异。这表明广泛使用的 HbA _1c测量可能会低估或高估糖尿病并发症的风险，这可能会对未来的临床产生影响。