Novel indicator of microvascular complications in patients with type 2 diabetes mellitus and shortened erythrocyte lifespan: a multicenter cross-sectional analysis

Abstract Introduction In this study, we assessed whether the ratio of glucose management index (GMI) to glycated albumin (GA) was linked to microvascular complications in patients with type 2 diabetes mellitus (T2DM) who also possessed a shortened erythrocyte lifespan. Methods This study encompassed...

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Main Authors: Yunqi Wu, Binshan Zhang, Xin Ma, Pei Yu, Saijun Zhou, Xinli Wang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01591-1
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Summary:Abstract Introduction In this study, we assessed whether the ratio of glucose management index (GMI) to glycated albumin (GA) was linked to microvascular complications in patients with type 2 diabetes mellitus (T2DM) who also possessed a shortened erythrocyte lifespan. Methods This study encompassed individuals from the Tianjin Diabetic Retinopathy Screening Cohort who completed continuous glucose monitoring and had an erythrocyte lifespan of under 90 days. Differences in GMI/GA were compared between the T2DM patients with or without microvascular complications, including diabetic kidney disease (DKD) and diabetic retinopathy (DR). The relationship between GMI/GA and microvascular complications (DKD and/or DR) was assessed by dividing GMI/GA into three groups based on tertiles. Results Our study comprised 140 participants with T2DM (62 men and 78 women, with a median age of 67 years) with a median DM duration of 9.68 years, a mean glycated hemoglobin A1c (HbA1c) value of 7.10%, and a median GA value of 16.10%. As expected, the lower GMI/GA group exhibited higher HbA1c and GA (P < 0.001) with similar mean glucose levels (P = 0.099). GMI/GA values were significantly higher in participants without microvascular complications than in those with microvascular complications, including DKD and/or DR (P < 0.05). After adjusting for confounders, the lowest GMI/GA group (T1) had a 3.601-fold increased risk of microvascular complications (95% CI, 1.364–9.508, P = 0.010) and a 3.830-fold increased risk of DKD, specifically (95% CI, 1.364–12.222, P = 0.023) relative to the highest group (T3). Conclusion GMI/GA serves as a novel risk indicator for microvascular complications in T2DM, independent of HbA1c.
ISSN:1758-5996