Evaluation of HbA1c from CGM traces in an Indian population

The continuous glucose monitoring (CGM) traces from any individual can be considered a sequence of snapshots of their interstitial fluid glucose concentration (ISF). These snapshots can be considered to be a representation of that individual’s ISF dynamics. This is a relatively new tool and there has been various attempts to use CGM traces to understand the glucose-insulin dynamics of the human body for example, estimating various metrics used to diagnose Diabetes Mellitus (DM) such as HbA1c, fasting blood glucose (FBG), etc. In this manuscript we have developed two methods for estimating HbA1c of an individual from the Indian population. We showed that the HbA1c estimated from the CGM traces, using these two methods, were statistically indistinguishable from the measured HbA1c.

Estimating HbA1c from an individual’s CGM trace is still an open problem, various methods have been developed over the years. One such popular method was published in Nathan et al., 2008 ¹. In this manuscript, we developed two similar methods. First, the direct method and the second the adapted Nathan model that provides statistically reliable HbA1c estimates using CGM traces from individuals of the Indian population.