Hemoglobin glycation index among adults with type 1 diabetes: Association with double diabetes features

doi:10.4239/wjd.v16.i4.100917

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Diabetes. Apr 15, 2025; 16(4): 100917
Published online Apr 15, 2025. doi: 10.4239/wjd.v16.i4.100917

Table 1 Characteristics of the study participants, n (%)

Characteristics	T1D (n = 83)
Male	33 (39.8)
Age (years), median (25^th-75^th percentiles)	32.8 (26.7, 38.0)
Age at onset (years), median (25^th-75^th percentiles)	14.8 (9.9, 23.0)
Duration of diabetes (years), median (25^th-75^th percentiles)	15.1 (13.2, 19.1)
GADA +, IA-2A +, or ZnT8A +	50 (60.2)
Preserved β-cell function	52 (62.7)
Insulin pump users	37 (44.6)
Daily insulin dose (U/kg/day), median (25^th-75^th percentiles)	0.60 (0.50, 0.72)
DD features
0	26 (31.3)
1-2	37 (44.6)
≥ 3	20 (24.1)
Positive family history of T2D	16 (19.3)
Hypertension	10 (12.0)
Atherogenic dyslipidemia	9 (10.8)
Overweight/obesity/central obesity	18 (21.7)
Abnormal PBF and/or VFA	38 (45.8)
eIS ≤ 4.66 mg/kg/minute	29 (34.9)
HbA1c, median (25^th-75^th percentiles)	6.9 (6.3, 7.6)
Mean glucose (mmol/L), median (25^th-75^th percentiles)	7.4 (6.6, 8.2)
GMI, median (25^th-75^th percentiles)	6.5 (6.2, 6.8)
HGI, median (25^th-75^th percentiles)	0.35 (0.02, 1.06)
TBR (< 3.0 mmol/L), median (25^th-75^th percentiles)	0.80 (0.20, 1.75)
TBR (< 3.9 mmol/L), median (25^th-75^th percentiles)	7.6 (5.0, 11.5)
TIR, median (25^th-75^th percentiles)	73.7 (63.2, 83.5)
TAR (> 10.0 mmol/L), median (25^th-75^th percentiles)	17.5 (7.6, 26.9)
TAR (> 13.9 mmol/L), median (25^th-75^th percentiles)	2.2 (0.3, 7.2)
Coefficient of variation, median (25^th-75^th percentiles)	36.1 (31.3, 41.1)
MAGE (mmol/L), median (25^th-75^th percentiles)	6.0 (4.7, 7.6)
Diabetic nephropathy	12 (14.4)
Diabetic retinopathy	22 (26.5)
Diabetic peripheral neuropathy	16 (19.3)
Diabetic microangiopathy	33 (39.8)
Atherosclerosis	13 (15.7)

T1D: Type 1 diabetes; GADA: Glutamic acid decarboxylase antibody; IA-2A: Insulinoma-associated protein 2 antibody; ZnT8A: Zinc transporter 8 antibody; DD: Double diabetes; T2D: Type 2 diabetes; PBF: Percent total body fat; VFA: Visceral fat area; eIS: Estimated insulin sensitivity; HbA1c: Glycated hemoglobin; GMI: Glucose management indicator; HGI: Hemoglobin glycation index; TBR: Time below range; TIR: Time in range; TAR: Time above range; MAGE: Mean amplitude glycemic excursion.

Table 2 Characteristics among different hemoglobin glycation index groups, n (%)

Characteristics	Low HGI (n = 28)	Moderate HGI (n = 28)	High HGI (n = 27)	P value
Male	13 (46.4)	9 (32.1)	11 (40.7)	0.546
Age (years), median (25^th-75^th percentiles)	33.6 (25.5, 37.7)	32.7 (27.8, 39.4)	32.8 (26.7, 37.0)	0.850
Age at onset (years), median (25^th-75^th percentiles)	14.6 (9.7, 23.8)	15.5 (10.4, 22.6)	16.7 (9.5, 23.0)	0.940
Duration of diabetes (years), median (25^th-75^th percentiles)	15.2 (12.2, 20.2)	14.3 (12.4, 18.6)	15.2 (13.9, 20.0)	0.618
GADA +, IA-2A +, or ZnT8A +	17 (60.7)	20 (71.4)	13 (48.1)	0.211
Preserved β-cell function	19 (67.9)	20 (71.4)	13 (48.1)	0.159
Insulin pump users	14 (50.0)	15 (53.6)	8 (29.6)	0.158
Daily insulin dose (U/kg/day), median (25^th-75^th percentiles)	0.60 (0.51, 0.72)	0.54 (0.48, 0.64)	0.66 (0.53, 0.81)	0.103
Taking lipid-lowering medications	2 (7.1)	3 (10.7)	3 (11.1)	0.904
Taking oral hypoglycemic drugs	3 (10.7)	5 (17.9)	4 (14.8)	0.748
Dietary carbohydrate, median (25^th-75^th percentiles)	53.3 (37.8, 60.6)	51.8 (46.8, 58.8)	48.6 (46.0, 53.6)	0.755
Dietary fat, median (25^th-75^th percentiles)	28.2 (19.7, 35.0)	26.9 (23.1, 30.3)	29.3 (24.7, 30.8)	0.747
Dietary protein, median (25^th-75^th percentiles)	19.7 (17.4, 23.8)	19.2 (16.8, 21.9)	20.4 (18.8, 23.2)	0.476
MET-minute/week, median (25^th-75^th percentiles)	2144.0 (643.5, 3304.5)	1173.0 (490.0, 2013.0)	1386.0 (990.0, 2270.0)	0.414
DD features				0.025
0¹	13 (46.4)	10 (35.7)	3 (11.1)
1-2	12 (42.9)	12 (42.9)	13 (48.1)
≥ 3¹	3 (10.7)	6 (21.4)	11 (40.7)
Hemoglobin (g/L), median (25^th-75^th percentiles)	143.5 (132.5, 152.5)	135.5 (121.5, 149.0)	131.0 (121.0, 146.0)	0.082
RBC count (10¹²/L), median (25^th-75^th percentiles)	4.6 (4.4, 4.9)	4.5 (4.2, 4.8)	4.5 (4.1, 4.9)	0.757
Mean glucose (mmol/L), median (25^th-75^th percentiles)	6.9 (6.6, 7.6)	7.3 (6.4, 8.1)	8.1 (6.8, 8.5)	0.102
TBR (< 3.0 mmol/L), median (25^th-75^th percentiles)	0.70 (0.10, 1.29)	0.80 (0.20, 1.51)	0.70 (0.18, 2.39)	0.828
TBR (< 3.9 mmol/L), median (25^th-75^th percentiles)	7.8 (5.0, 9.6)	6.7 (5.7, 12.0)	7.8 (4.8, 12.0)	0.994
TIR, median (25^th-75^th percentiles)	78.2 (70.1, 85.9)	73.3 (65.7, 82.1)	65.4 (52.2, 83.5)	0.113
TAR (> 10.0 mmol/L), median (25^th-75^th percentiles)	11.5 (7.8, 20.5)	18.2 (7.3, 27.4)	24.7 (6.2, 34.5)	0.143
TAR (> 13.9 mmol/L), median (25^th-75^th percentiles)	1.2 (0.2, 3.0)	2.4 (0.3, 6.6)	3.9 (0.6, 10.7)	0.135
Coefficient of variation, median (25^th-75^th percentiles)	36.6 (31.7, 40.9)	36.1 (32.6, 40.0)	35.7 (30.0, 43.3)	0.959
MAGE (mmol/L), median (25^th-75^th percentiles)	5.5 (4.6, 6.6)	6.3 (5.4, 7.3)	7.3 (4.9, 8.5)	0.446
Diabetic microangiopathy	7 (25.0)	10 (35.7)	16 (59.3)	0.030
Atherosclerosis	3 (10.7)	5 (17.9)	5 (18.5)	0.674

¹Significant difference between high and low hemoglobin glycation index group, corrected for multiple comparisons using the Bonferroni method.

HGI: Hemoglobin glycation index; GADA: Glutamic acid decarboxylase antibody; IA-2A: Insulinoma-associated protein 2 antibody; ZnT8A: Zinc transporter 8 antibody; MET: Metabolic equivalent; DD: Double diabetes; RBC: Red blood cell; TBR: Time below range; TIR: Time in range; TAR: Time above range; MAGE: Mean amplitude glycemic excursion.

Table 3 Correlation of double diabetes-related metabolic parameters with hemoglobin glycation index

DD-related metabolic parameters	β	P value
BMI (kg/cm²)	0.268	0.017
WC (cm)	0.292	0.009
SBP (mmHg)	0.136	0.233
DBP (mmHg)	0.152	0.182
HDL-C (mmol/L)	-0.076	0.508
TG (mmol/L)	0.471	< 0.001
PBF (%)	0.280	0.012
VFA (cm²)	0.290	0.010
eIS (mg/kg/minute)	-0.454	< 0.001

Data are beta coefficients and P values from partial correlation analysis. Confounding variables adjusted: Age, gender, duration of diabetes and hemoglobin.

DD: Double diabetes; BMI: Body mass index; WC: Waist circumference; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; HDL-C: High-density lipoprotein-cholesterol; TG: Triglyceride; PBF: Percent total body fat; VFA: Visceral fat area; eIS: Estimated insulin sensitivity.

Table 4 Multivariable regression model for hemoglobin glycation index

Variables	Standardized β	P value
Age (years)	-0.016	0.918
Male	-0.109	0.355
Duration of diabetes (years)	0.182	0.081
Hemoglobin (g/L)	-0.408	0.004
eIS (mg/kg/minute)	-0.466	< 0.001
VFA (cm²)	0.233	0.042

Data include model performance (R² = 0.313 and P < 0.001), standardized coefficients β and P value, with age, gender, duration of diabetes and hemoglobin entered into the first layer, and possible risk factors incorporated into the second layer (forward selection stepwise; P < 0.05 criterion for variable retention). Variables that did not enter into the final model were not included in the table. VFA: Visceral fat area; eIS: Estimated insulin sensitivity.

Citation: Ji XL, Yin M, Deng C, Fan L, Xie YT, Huang FS, Chen Y, Li X. Hemoglobin glycation index among adults with type 1 diabetes: Association with double diabetes features. World J Diabetes 2025; 16(4): 100917
URL: https://www.wjgnet.com/1948-9358/full/v16/i4/100917.htm
DOI: https://dx.doi.org/10.4239/wjd.v16.i4.100917