Objective To explore the relationship between glycated albumin (GA)/glycosylated hemoglobin (HbA1c) ratio and parameters of continuous glucose monitoring (CGM) in patients with type 2 diabetes mellitus (T2DM).

Method A total of 100 patients with T2DM were enrolled, who was admitted to the Department of Endocrinology, Zhongshan Hospital, Fudan University for the first time between January 2020 and December 2021, and were grouped by GA/HbA1c ratio tertiles. Each patient wore a flash scanning continuous glucose meter, and their 72-hour blood glucose values on the 3rd to 5th day after admission were recorded. The average blood glucose, mean amplitude of glycemic excursion (MAGE), the difference between the highest and lowest blood glucose ( ∆BG), time in range (TIR), time above range (TAR), and time below range (TBR) were calculated. The correlations of GA/HbA1c ratio and CGM parameters were analyzed.

Results With the increase of GA/HbA1c ratio, MAGE, fasting blood glucose (FBG), and ∆BG increased, the peak value of post-arginine C-peptide decreased (P < 0.05). Pearson or Spearman rank correlation analyses showed that GA/HbA1c ratio was negatively correlated with fasting C-peptide, post-arginine C-peptide and TIR (P < 0.01), while it was positively correlated with FBG, ∆BG, and MAGE (P < 0.05). No correlation was found between GA/HbA1c ratio and the number of complications. Multiple linear regression analysis showed that GA/HbA1c ratio was independently correlated with MAGE, ∆BG and TIR (P < 0.05). Logistic regression analysis showed that GA/HbA1c ratio was independently correlated with targeted TIR (OR=6.990, 95% CI 2.179-22.423, P < 0.01).

Conclusion The GA/HbA1c ratio is related to the residual islet β-cell function in T2DM patients, and is independently related to MAGE, ∆BG and TIR and could be used as an indicator for glucose control.