LIEDTKE, J.A.E.M. (2024) Glycation Ratio: Navigating the Debate on its Clinical Relevance. thesis, Medicine.
Full text available on request.Abstract
Introduction: HbA1c is commonly used to assess long-term glycemic control, but it may not fully account for individual differences in glycation, potentially misclassifying patient risk. This study examines whether the glycation ratio (GR), calculated by dividing the Glucose Management Indicator (GMI) by lab-measured HbA1c, provides additional predictive value for microvascular complications in type 2 diabetes (T2DM) patients. Methods: A cross-sectional analysis was conducted using data from 183 T2DM patients in the Diabetes and Lifestyle Cohort Twente (DIALECT). GR was calculated from two weeks of blinded glucose monitoring and the lab measured HbA1c. Patients were grouped into three clusters (low, moderate, high GR) using a k-means algorithm to assess the association between GR and microvascular complications. Results: The clusters identified were low GR (0.7 ± 0.1, n = 50), moderate GR (0.9 ± 0.1, n = 97), and high GR (1.1 ± 0.2, n = 36). Time Below Range (TBR) was highest in the low GR cluster (6.68 ± 8.02, p = 0.002). BMI was highest in the high GR cluster (31.1 ± 1.2 kg/m²) and was significantly associated with microvascular complications (p < 0.01). Smoking status significantly interacted with microvascular outcomes in the low GR cluster (p = 0.032). Conclusion: GR could provide additional insights beyond HbA1c in predicting complications in T2DM patients. Integrating GR into clinical practice could improve risk stratification and personalized treatment. Further research is needed to validate these findings.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Laverman, prof.dr. G. D. |
| Faculty: | Medical Sciences |
| Date Deposited: | 31 Oct 2025 14:13 |
| Last Modified: | 31 Oct 2025 14:13 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3844 |
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