Individualized Diabetes Management Research Articles

The Association of Sociodemographic Factors and Utilization of Diabetes Technologies with Diabetes Management: An Investigation in Children and Adolescents with Type 1 Diabetes.

We aimed to investigate the relationship between sociodemographic and clinical characteristics, as well as the utilization of diabetes technologies, with diabetes management in individuals with type 1 diabetes (T1D). Our study included 134 cases diagnosed with T1D who were followed for at least 1 year with T1D. Of the cases, 67.2% were using insulin pens as their insulin regimen, while 37.8% were using insulin pumps. The rate of continuous glucose monitoring (CGM) usage was 29.9%. The rate of CGM usage was 5% in families with low income levels. Glycosylated hemoglobin A1c(HbA1c) level of children with working mothers was found to be higher compared to those with non-working mothers (median 9.2% vs. 8%; P = .009). Cases with 3 or more siblings had higher HbA1c levels compared to those with 2 or fewer siblings (median 8.7% vs. 8.1%; P = .044).The median HbA1c was 8.7% in cases using insulin pens and checking fingerstick blood glucose (SMBG); 8.3% in cases using insulin pumps and SMBG; 7.6% in cases using insulin pens with CGM, and 7.5% in cases using insulin pumps with CGM (P = .003). The utilization of insulin pumps with CGM in T1D cases exhibited lower HbA1clevels. Similarly, even the usage of insulin pens with CGM demonstrated improved diabetes management. Maternal employment and having a higher number of siblings may negatively affect diabetes management due to increased caregiver burden. We believe that personalized healthcare delivery tailored to the individual needs of T1D patients based on family and clinical characteristics could have positive effects on diabetes management.

Integrated image-based deep learning and language models for primary diabetes care

Primary diabetes care and diabetic retinopathy (DR) screening persist as major public health challenges due to a shortage of trained primary care physicians (PCPs), particularly in low-resource settings. Here, to bridge the gaps, we developed an integrated image–language system (DeepDR-LLM), combining a large language model (LLM module) and image-based deep learning (DeepDR-Transformer), to provide individualized diabetes management recommendations to PCPs. In a retrospective evaluation, the LLM module demonstrated comparable performance to PCPs and endocrinology residents when tested in English and outperformed PCPs and had comparable performance to endocrinology residents in Chinese. For identifying referable DR, the average PCP’s accuracy was 81.0% unassisted and 92.3% assisted by DeepDR-Transformer. Furthermore, we performed a single-center real-world prospective study, deploying DeepDR-LLM. We compared diabetes management adherence of patients under the unassisted PCP arm (n = 397) with those under the PCP+DeepDR-LLM arm (n = 372). Patients with newly diagnosed diabetes in the PCP+DeepDR-LLM arm showed better self-management behaviors throughout follow-up (P < 0.05). For patients with referral DR, those in the PCP+DeepDR-LLM arm were more likely to adhere to DR referrals (P < 0.01). Additionally, DeepDR-LLM deployment improved the quality and empathy level of management recommendations. Given its multifaceted performance, DeepDR-LLM holds promise as a digital solution for enhancing primary diabetes care and DR screening.

Inhaled Technosphere Insulin for Individualized Diabetes Management: 3 Case Reports of CGM Outcomes

Inhaled Technosphere Insulin for Individualized Diabetes Management: 3 Case Reports of CGM Outcomes

Determination of diabetes care profile and diabetes management in individuals with type 2 diabetes: turkey survey

Determination of diabetes care profile and diabetes management in individuals with type 2 diabetes: turkey survey

Integrated Care Approaches: Optimizing Diabetes Management in Sickle Cell Anemia

This review article delves into the intricate landscape of diabetes management in individuals with sickle cell anemia, emphasizing the imperative need for integrated care strategies. The coexistence of these two chronic conditions poses unique challenges that warrant a multidisciplinary and personalized approach. Through an exploration of the current understanding of the interplay between sickle cell anemia and diabetes, this review highlights the role of collaborative interventions, technological innovations, and patient education in achieving optimal outcomes. The integration of various healthcare disciplines, coupled with personalized medicine and patient empowerment, emerges as a key theme in navigating the complexities of managing diabetes in the context of sickle cell anemia. As the medical community continues to evolve, embracing integrated care models becomes essential for addressing the nuanced needs of individuals grappling with these comorbidities.

Phenotypic characterization of nonautoimmune diabetes in adult Ugandans with low body mass index.

Type 2 diabetes is common in relatively lean individuals in sub-Saharan Africa. It is unclear whether phenotypic differences exist between underweight and normal-weight African patients with type 2 diabetes. This study compared specific characteristics between underweight (body mass index <18.5 kg/m2) and normal-weight (body mass index of 18.5-24.9 kg/m2) adult Ugandans with new-onset nonautoimmune diabetes. We collected the demographic, clinical, anthropometric, and metabolic characteristics of 160 participants with nonobese new-onset type 2 diabetes (defined as diabetes diagnosed <3 months, body mass index <25 kg/m2, and absence of islet-cell autoimmunity). These participants were categorized as underweight and normal weight, and their phenotypic characteristics were compared. Of the 160 participants with nonobese new-onset type 2 diabetes, 18 participants (11.3%) were underweight. Compared with those with normal weight, underweight participants presented with less co-existing hypertension (5.6% versus 28.2%, p = 0.04) and lower median visceral fat levels [2 (1-3) versus 6 (4-7), p < 0.001], as assessed by bioimpedance analysis. Pathophysiologically, they presented with a lower median 120-min post-glucose load C-peptide level [0.29 (0.13-0.58) versus 0.82 (0.39-1.50) nmol/l, p = 0.04] and a higher prevalence of insulin deficiency (66.7% versus 31.4%, p = 0.003). This study demonstrates that nonautoimmune diabetes occurs in underweight individuals in sub-Saharan Africa and is characterized by the absence of visceral adiposity, reduced late-phase insulin secretion, and greater insulin deficiency. These findings necessitate further studies to inform how the prevention, identification, and management of diabetes in such individuals can be individualized.

Exploring the Interrelationships between Diabetes, Nutrition, Anxiety, and Depression: Implications for Treatment and Prevention Strategies.

Across the world, diabetes, depression, and anxiety symptoms have gained widespread recognition as significant public health issues. Recent research has unveiled a mutually influential relationship between diabetes and these two mental health conditions, where each disorder impacts the course and outcomes of the others. The role of nutrition emerges as pivotal in preventing and treating depression, anxiety, and diabetes. A thorough literature review was undertaken to investigate the reciprocal effects between anxiety, depression, and diabetes, including their impact on the development and severity of each condition. Additionally, the effects of nutrition on the prevention and management of depression, anxiety, diabetes, and related complications in at-risk individuals were assessed. Our findings show that mental disorders, such as depression and anxiety, increase the risk of developing type 2 diabetes and are associated with poorer glycemic control, increased diabetes-related complications, and higher mortality rates. Conversely, diabetes is also linked with an increased risk of developing depression and anxiety. The biological, psychological, and social factors that contribute to the comorbidity between these two conditions are complex and multifaceted. Therefore, an integrated approach to the management of both conditions is critical for improving patient outcomes and reducing the overall burden of disease. Nutritional interventions should be utilized to reduce the risk of diabetes in patients with anxiety and depression as well as enhance mental health in patients with diabetes.

124-LB: Randomized Trial of Continuous Glucose Monitors for the Care of Pregnant People to Limit Staff Exposure

Introduction: During a pandemic, use of remote monitors may reduce close patient contact and decrease risk of occupational exposure. This study evaluated the impact of continuous glucose monitor (CGM) use on the number of close encounters required for diabetes management in pregnant individuals. Methods: This study included 24 pregnant people with pregestational diabetes or medication-controlled gestational diabetes admitted for antepartum care. Participants received a Dexcom G6 CGM and were randomized to clinical use of CGM (intervention) or to standard care with fingerstick point-of-care (POC) glucose checks and a CGM device in blinded mode (control). The primary outcome was the number of POC glucose measurements per nursing shift. Secondary outcomes included glycemic control, neonatal outcomes, and patient and nursing satisfaction measured with surveys. Results: Patients in the intervention group required fewer POC measurements per shift than the control group, but this difference did not reach statistical significance (1.56 ± 0.88 vs 2.28 ± 1.17, p=0.08). Time in the pregnancy-recommended glycemic range (63-140 mg/dL) was similar in both the intervention and the control groups (77.65% ± 22.95 vs. 73.30% ± 27.23, p = 0.89). Time above range (21.64% ± 23.49 vs. 24.84% ± 27.82, p = 0.95) and below range (0.70% ± 1.58 vs. 1.86% ± 4.93, p = 0.64) were also comparable in the intervention and control patients. Neonatal intensive care unit (NICU) admission, neonatal hypoglycemia, hyperbilirubinemia and supplemental oxygen were less likely in the intervention group, however this difference was not significant when adjusted for gestational age at delivery. Patient and nursing satisfaction was high in both groups and not significantly different. Conclusion: Although use of CGM's for antepartum admissions did not significantly decrease close patient contact, equivalent glycemic control was achieved as with standard care. Neonatal outcomes were also similar in both groups. Disclosure J. Grasch: Research Support; Dexcom, Inc., TrueRelief, LLC. N. Nandam: None. E. Buschur: Consultant; Beta Bionics, Inc., Research Support; Dexcom, Inc., JDRF, Leona M. and Harry B. Helmsley Charitable Trust. Funding Dexcom, Inc. (IIS-2020-052)

Self-esteem mediates the relationship perceived stigma with self-efficacy for diabetes management in individuals with type 2 diabetes mellitus.

To determine the mediating effect of self-esteem in the relationship between the perceived stigmatization of individuals with type 2 diabetes mellitus (T2DM) and their self-efficacy regarding diabetes management. The study was carried out with 162 patients with T2DM who visited the Internal Medicine outpatient clinic, Bartin Public Hospital, Bartin, Turkey, between December 2020 and May 2021. A descriptive information form, diabetes management self-efficacy scale, Rosenberg self-esteem scale, and type-2 diabetes stigma assessment scale were used in data collection. As a result of regression analyses, it was determined that the variables of stigmatization (ß= -0.294) and self-esteem (ß=0.875) had a significant predictive effect on self-efficacy of patients with T2DM, and that as self-esteem was added to the model, the effect of stigmatization on self-efficacy (ß= -0.294) decreased (ß= -0.230, p<0.05). According to these findings and the results of the Sobel test, it was determined that self-esteem had a partial mediator role (z= -3.347; p< 0.05). Minimizing the perceived stigmatization can improve patients' diabetes management self-efficacy. With patient training programs and individualized nursing care plans prepared by psychiatric nurses to provide psychological support patients and through their interventions that increase self-esteem, self-stigmatization can be reduced.

A retrospective study of diabetes treatment in older adults: what should we AIM for?

ABSTRACT Objectives Management of diabetes in elderly individuals requires a complex approach, considering the negative consequences. Glycemic overtreatment and undertreatment are relatively common conditions among this population. This study aimed to determine the potential overtreatment and undertreatment frequencies in older adults and the factors associated with these conditions. Methods This retrospective study included 405 diabetic older adults aged >65 years. Sociodemographic characteristics, additional comorbidities, medications, HbA1c and fasting glucose levels of the patients have been recorded. Results The median age of the patients was 71 years. The frequency of potential overtreatment and undertreatment has been found to be 20.2% and 17.8%, respectively. Insulin and sulfonylureas were found to be associated with increased risk of potential overtreatment (p = 0.000, OR = 14.91 and p = 0.000, OR = 8.48, respectively) and reduced risk of potential undertreatment (p = 0.001, OR = 0.16 and p = 0.000, OR = 0.05, respectively), while DPP-4 inhibitors were found to be associated with reduced risk of potential undertreatment (p = 0.000, OR = 0.12). Conclusion Our study has shown that potential glycemic overtreatment and undertreatment are common problems in diabetic older adults. It was found that agents with a high risk of hypoglycemia, such as insulin and sulfonylureas, were more closely associated with potential overtreatment. In the management of diabetes in the elderly, it should be aimed to choose treatment agents that lead to less negative consequences and to follow up the patients more closely.

Development of a Novel Insulin Sensor for Clinical Decision-Making.

Clinical decision support systems that incorporate information from frequent insulin measurements to enhance individualized diabetes management remain an unmet goal. The development of a disposable insulin strip for fast decentralized point-of-care detection replacing the current centralized lab-based methods used in clinical practice would be highly desirable to improve the establishment of individual insulin absorption patterns and algorithm modeling processes. We carried out the development and optimization of a novel decentralized disposable insulin electrochemical sensor focusing on obtaining high analytical and operational performance toward achieving a true point-of-care insulin testing device for clinical on-site application. Our novel insulin immunosensor demonstrated an attractive performance and efficient user-friendly operation by providing high sensitivity capability to detect endogenous and analog insulin with a limit of detection of 30.2 pM (4.3 µiU/mL), rapid time-to-result, stability toward remote site application, and scalable low-cost fabrication with an estimated cost-of-goods for disposable consumables of below $5, capable of near real-time insulin detection in a microliter (≤10 µL) sample droplet of undiluted serum within 30 minutes. The results obtained in the optimization and characterization of our novel insulin sensor illustrate its suitability for its potential application in remote clinical environments for frequent insulin monitoring. Future work will test the insulin sensor in a clinical research setting to assess its efficacy in individuals with type 1 diabetes.

Hypoglycaemia in older home-dwelling people with diabetes- a scoping review

BackgroundHypoglycaemia is associated with cognitive and functional decline in older people with diabetes. Identification of individuals at risk and prevention of hypoglycaemia is therefore an important task in the management of diabetes in older home-dwelling individuals. The purpose of this scoping review was to map the literature on hypoglycaemia in home-dwelling older people with diabetes.MethodsThis scoping review included original research articles on hypoglycaemia in older (≥ 65 years) individuals with diabetes from developed countries. A broad search of the databases Cinahl, Embase and Medline was performed in July 2018. The report of the scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews.ResultsOur database search identified 577 articles of which 23 were eligible for inclusion. The identified literature was within four areas: 1) incidence of hypoglycaemia in older home-dwelling people with diabetes (11/23 articles), 2) risk factors of hypoglycaemia (9/23), 3) diabetes knowledge and self-management (6/23) and 4) consequences of hypoglycaemia for health care use (6/23). The majority of the literature focused on severe hypoglycaemia and the emergency situation. The literature on diabetes knowledge and management related to preventing adverse events relevant to older home-dwellers, was limited. We found no literature on long-term consequences of hypoglycaemia for the use of home health care services and the older persons’ ability to remain home-dwelling.ConclusionsWe identified a lack of studies on prevention and management of hypoglycaemia in the older individuals’ homes. Such knowledge is of utmost importance in the current situation where most western countries’ governmental policies aim to treat and manage complex health conditions in the patient’s home. Future studies addressing hypoglycaemia in older individuals with diabetes are needed in order to tailor interventions aiming to enable them to remain home-dwelling as long as possible.

Values informing the development of an indicator of appropriate diabetes therapy: qualitative study

ObjectivesDespite increasing focus on individualised diabetes management, current diabetes quality measures are based on meeting generic haemoglobin A1c thresholds and do not reflect considerations of clinical complexity, hypoglycaemic susceptibility or...

Patient perspectives on the use of half-unit insulin pens by people with type 1 diabetes: a cross-sectional observational study

Background Half-unit pens offer the ability to dose insulin more precisely. Information about half-unit pen use and evidence of their benefits and drawbacks is limited. This study aims to characterize people with type 1 diabetes (T1D) who have used (current/former = EVER) vs. those who have never used half-unit pens (NEVER users) and to understand their perspective. Methods An observational cross-sectional online survey was administered through T1D Exchange’s online patient community, myGlu.org, to understand the use of half-unit insulin pens. Results The 278 adult participants (156 EVER, 122 NEVER) had a mean age of 41.8 ± 12.7 years, body mass index of 26.0 ± 3.8 kg/m2, glycated hemoglobin of 6.3% ± 1.0%, and 55% were male. EVER users had T1D for a shorter duration than NEVER users (p < .001). EVER users were less likely to use continuous subcutaneous insulin infusion (p < .001) and more likely to start correcting high blood glucose at a lower level (p < .001) and low blood glucose at a higher level (p < .001). The highest ranked benefits of half-unit pen reported by its current users (N = 131) included prevention of hyperglycemia (40.5%), less anxiety or worry (23.7%), and prevention of hypoglycemia (16.8%). Conclusions Half-unit insulin pen is perceived as an insulin device that may help people with T1D to avoid hypo- and hyperglycemic events and decrease their level of disease worry and anxiety. This study highlights the need for patients and health care providers to understand the benefits of half-unit pens while considering options for individualized diabetes management.

A Group-Based Community Reinforcement Approach of Cognitive Behavioral Therapy Program to Improve Self-Care Behavior of Patients With Type 2 Diabetes.

IntroductionThis study evaluated a cognitive behavioral-based self-care intervention program on diabetes management in individuals with type 2 diabetes in Jiangsu Province, China. People with type 2 diabetes were recruited to a 6-month, prospective, intervention study.MethodsThe intervention group (n = 296) received an intensive cognitive behavioral-based self-care intervention, including group activities, frequent blood glucose monitoring, nutritional counseling, diabetes-specific meal and a weekly progress report. The control group (n = 110) received diabetes education, including diet and physical activity instruction only. Assessment data was obtained at baseline, and after 12 and/or 24 weeks of intervention. The intention to treat method was used to assess the effectiveness of the intervention program.ResultsThe intervention group showed improved fasting blood glucose, HbA1c, systolic and diastolic blood pressures compared to the control group. The intervention group also had significantly improved knowledge and self-care behavior, and general health.ConclusionThis study demonstrates that significant improvement in glycemic control and markers of cardiovascular health can occur in Chinese people with type 2 diabetes following a CBT-based intervention program that includes diabetes education, frequent blood glucose monitoring and daily use of a diabetes-specific meal plan, suggesting CBT is beneficial to improve health outcome in patients with type 2 diabetes.

Diabetes Management in Individuals with Severe Mental Illness and the Role of the Psychiatric Nurse

Diabetus mellitus dirençli hiperglisemi ile karakterize kompleks metabolik bir bozukluktur. Kronik ruhsal hastalığı olan bireylerde diyabet görülme oranı sağlıklı popülasyona göre daha yüksektir. Genetik ve yaşam biçimini içeren birçok faktöre bağlı olarak geliştiği bilinen tip 2 diyabetin, ikinci kuşak antipsikotik ilaçların kilo artışı, glikoz metabolizma bozuklukları gibi yan etkisi nedeniyle kronik ruhsal hastalığı olan bireylerde görülme riski artmaktadır. Diyabet yönetiminde sağlıklı yaşam biçimini teşvik etme, tarama ve izleme tedavinin önemli parçasıdır. Kronik ruhsal hastalığı olan bireylerde diyabet oranlarındaki bu artış ve hastaların her iki hastalığı yönetmelerinde yaşadığı zorluklar sağlık bakımında yeni yaklaşımları gerektirmektedir. Bu derlemenin amacı kronik ruhsal hastalığı olan bireylerde diyabet sıklığının, yönetiminin nasıl olduğuna ve psikiyatri hemşirelerinin rollerine ışık tutmaktır.

Diabetes-Related Topics in an Online Forum for Caregivers of Individuals Living With Alzheimer Disease and Related Dementias: Qualitative Inquiry.

BackgroundDiabetes and Alzheimer disease and related dementias (ADRD) are the seventh and sixth leading causes of death in the United States, respectively, and they coexist in many older adults. Caring for a loved one with both ADRD and diabetes is challenging and burdensome.ObjectiveThis study aims to explore diabetes-related topics in the Alzheimer’s Association ALZConnected caregiver forum by family caregivers of persons living with ADRD.MethodsUser posts on the Alzheimer’s Association ALZConnected caregiver forum were extracted. A total of 528 posts related to diabetes were included in the analysis. Of the users who generated the 528 posts, approximately 96.1% (275/286) were relatives of the care recipient with ADRD (eg, child, grandchild, spouse, sibling, or unspecified relative). Two researchers analyzed the data independently using thematic analysis. Any divergence was discussed among the research team, and an agreement was reached with a senior researcher’s input as deemed necessary.ResultsThematic analysis revealed 7 key themes. The results showed that comorbidities of ADRD were common topics of discussions among family caregivers. Diabetes management in ADRD challenged family caregivers. Family caregivers might neglect their own health care because of the caring burden, and they reported poor health outcomes and reduced quality of life. The online forum provided a platform for family caregivers to seek support in their attempts to learn more about how to manage the ADRD of their care recipients and seek support for managing their own lives as caregivers.ConclusionsThe ALZConnected forum provided a platform for caregivers to seek informational and emotional support for caring for persons living with ADRD and diabetes. The overwhelming burdens with these two health conditions were apparent for both caregivers and care recipients based on discussions from the online forum. Studies are urgently needed to provide practical guidelines and interventions for diabetes management in individuals with diabetes and ADRD. Future studies to explore delivering diabetes management interventions through online communities in caregivers and their care recipients with ADRD and diabetes are warranted.

757-P: Financial Strain and Relationship Quality in Young Married Couples Managing Type 1 Diabetes

Over the last 5 years, individual diabetes management costs have increased 26%, with the average diabetes patient spending $16,752 per year and those with type 1 diabetes mellitus (T1DM) paying a disproportionately higher amount than their type 2 counterparts. With T1DM diagnoses increasing by around 40,000 each year and the majority of diagnoses among adolescents and emerging adults approaching financial independence with limited funds, young T1DM patients and their partners may experience relational strain that often accompanies financial stress. Using data from a nationally representative sample of over 2,000 young married couples involved in the CREATE study, we identified 16 couples wherein one partner had T1DM. Among these, 8 wives had T1DM and 8 husbands had T1DM. For comparisons, we matched these couples with others in the CREATE study based on household income, husband and wife education, and husband and wife approximate number of weekly hours worked. A total of 116 matches were found, for a total of 132 couples in the analytic sample. Among the 16 couples with T1DM, half earned less than $50,000 annually (mean = $50,000-60,000/year). Mean comparisons indicated that both partners in couples with T1DM reported higher levels of financial distress and worry compared to matched couples, albeit not at a statistically significant level. Financial distress and worry were both significant predictors of relationship quality a year later for all couples in the study. However, associations between financial distress and relationship quality did not differ for couples with T1DM. Additional research is needed to explore specific diabetes supplies costs and how these may relate to relationship quality. Disclosure J.B. Yorgason: None. J. Saylor: None. S. Rellaford: None. M.S. Porter: None. Funding Brigham Young University

Sleep-related disorders in patients with type 1 diabetes mellitus: current insights.

Type 1 diabetes mellitus (T1DM) is an autoimmune condition that results from destruction of beta cells in the pancreas. Several reviews have concluded that sleep contributes to poor glycemic control, diabetes management, and diabetes-related complications in individuals with T1DM and represents an untapped opportunity for intervention. However, at the current juncture, the American Diabetes Association’s Standards of Medical Care are devoid of recommendations about how to address sleep in the management of T1DM. This article summarizes reviews of sleep in youth and adults with T1DM and empirical studies that have examined various sleep parameters ranging from sleep disturbances (general, perceived sleep quality, sleepiness, awakenings, and sleep efficiency), sleep duration, sleep consistency, sleep-disordered breathing (SDB), and sleep architecture. The data show that many individuals with T1DM sleep less than recommendations; individuals with the poorest sleep have difficulties with diabetes management; and sleep deficiency including SDB often corresponds to several disease morbidities (neuropathy, nephropathy, etc). Mixed findings exist regarding direct associations of various sleep parameters and glycemic control. SDB appears to be just as prevalent, if not more, than other conditions that have been recommended for universal screening in individuals with T1DM. The article concludes with recommendations for collaborative research efforts to further elucidate the role of sleep in diabetes-related outcomes; investigations to test behavioral strategies to increase sleep quantity and consistency; and considerations for clinical care to address sleep.

A Kinetic Model for Glucose Levels and Hemoglobin A1c Provides a Novel Tool for Individualized Diabetes Management.

Regular assessment of glycated hemoglobin (HbA1c) is central to the management of patients with diabetes. Estimated HbA1c (eHbA1c) from continuous glucose monitoring (CGM) has been proposed as a measure that reflects laboratory HbA1c. However, discrepancies between the two markers are common, limiting the clinical use of eHbA1c. Therefore, developing a glycemic maker that better reflects laboratory HbA1c will be highly relevant in diabetes management. Using CGM data from two previous clinical studies in 120 individuals with diabetes, we derived a novel kinetic model that takes into account red blood cell (RBC) turnover, cross-membrane glucose transport, and hemoglobin glycation processes to individualize the relationship between glucose levels and HbA1c. Using CGM data and two laboratory HbA1c measurements, kinetic rate constants for RBC glycation and turnover were calculated. These rate constants were used to project future HbA1c, creating a new individualized glycemic marker, termed calculated HbA1c (cHbA1c). In contrast to eHbA1c, the new glycemic marker cHbA1c gave an accurate estimation of laboratory HbA1c across individuals. The model and data demonstrated a non-linear relationship between laboratory HbA1c and steady-state glucose and also showed that glycation status is modulated by age. Our kinetic model offers mechanistic insights into the relationship between glucose levels and glycated hemoglobin. Therefore, the new glycemic marker does not only accurately reflect laboratory HbA1c but also provides novel concepts to explain the mechanisms for the mismatch between HbA1c and average glucose in some individuals, which has implications for future clinical management.