{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:44:35Z","timestamp":1792118675759,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To clarify whether the glucose management indicator (GMI)\/glycated haemoglobin (HbA1c) ratio (GMI\/HbA1c ratio) is an independent predictor of microvascular complications in Type 1 diabetes (T1D).<\/jats:p>\n <\/jats:sec>\n \n Design and Methods<\/jats:title>\n Multicentre, cross\u2010sectional, observational study including subjects with T1D with at least 5\u2009years of evolution, users of continuous glucose monitoring (CGM) with a coverage \u2265\u200980% 56\u2009days prior to HbA1c. Logistic regression models were used to identify the factors independently associated with grouped microvascular complications and ocular disease.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n As per data, 1315 participants were included. Patients were classified into tertiles based on the GMI\/HbA1c ratio. High glycators were older than intermediate and low glycators (55.4 vs. 53.4 vs. 50.8\u2009years;\n p<\/jats:italic>\n \u2009<\u20090.001), respectively. Differences were also observed among the three groups with regard to average glucose (156.3 vs. 161.8 vs. 166.1\u2009mg\/dL;\n p<\/jats:italic>\n \u2009<\u20090.001), time in range (66.3% vs. 62.9% vs. 59.9%;\n p<\/jats:italic>\n \u2009<\u20090.001), time in tight range (42.9% vs. 39.9% vs. 37.1%;\n p<\/jats:italic>\n \u2009<\u20090.001), coefficient of variation (34.5% vs. 34.9% vs. 35.6%;\n p<\/jats:italic>\n \u2009=\u20090.023), GMI (7% vs. 7.2% vs. 7.3%;\n p<\/jats:italic>\n \u2009<\u20090.001) and HbA1c (8.1% vs. 7.3% vs. 6.6%;\n p<\/jats:italic>\n \u2009<\u20090.001). In the high glycators group, the prevalence of microvascular complications was higher than in the intermediate and low glycators (38.9% vs. 28.2% vs. 23.7%;\n p<\/jats:italic>\n \u2009<\u20090.001), respectively. Also, the prevalence of ocular disease (31% vs. 20.2% vs. 19.7%;\n p<\/jats:italic>\n \u2009<\u20090.001), nephropathy (14.9% vs. 8.3% vs. 6.2%;\n p<\/jats:italic>\n \u2009<\u20090.001) and polyneuropathy (10.6% vs. 6.8% vs. 3.4%;\n p<\/jats:italic>\n \u2009<\u20090.001) was higher in high glycators, The GMI\/HbA1c ratio was significantly associated with the presence of grouped microvascular complications (OR 0.71; 95% CI: 0.61\u20130.81;\n p<\/jats:italic>\n \u2009<\u20090.001) and ocular disease (OR 0.71; 95% CI: 0.61\u20130.82;\n p<\/jats:italic>\n \u2009<\u20090.001) after adjusting for clinical ad glucometric variables.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The GMI\/HbA1c ratio is associated with microvascular complications in this study. These results highlight the potential of this parameter in routine clinical practice for stratifying the risk of complications and for establishing individualized control goals and screening strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.71385","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:01:31Z","timestamp":1792116091000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between the\n GMI<\/scp>\n \/\n HbA1c<\/scp>\n Ratio and Microvascular Complications in Type 1 Diabetes: A Multicenter Cross\u2010Sectional Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4601-7997","authenticated-orcid":false,"given":"Sandra","family":"Herranz\u2010Antol\u00edn","sequence":"first","affiliation":[{"name":"Guadalajara University Hospital Guadalajara Spain"},{"name":"IDISCAM, Castilla\u2010La Mancha Health Research Institute Toledo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Asunci\u00f3n","family":"Mart\u00ednez\u2010Brocca","sequence":"additional","affiliation":[{"name":"Virgen de la Macarena Hospital Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"C\u00e1novas\u2010Molina","sequence":"additional","affiliation":[{"name":"Fuenlabrada University Hospital Fuenlabrada Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Arag\u00f3n\u2010Alonso","sequence":"additional","affiliation":[{"name":"Virgen de la Arrixaca University Hospital Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Brito\u2010Sanfiel","sequence":"additional","affiliation":[{"name":"Puerta de Hierro University Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9761-6888","authenticated-orcid":false,"given":"Jose Ignacio","family":"Mart\u00ednez\u2010Montoro","sequence":"additional","affiliation":[{"name":"Virgen de la Victoria University Hospital M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8384-043X","authenticated-orcid":false,"given":"Virginia","family":"Bellido","sequence":"additional","affiliation":[{"name":"Virgen del Rocio University Hospital Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharona","family":"Azriel","sequence":"additional","affiliation":[{"name":"Infanta Sof\u00eda University Hospital San Sebasti\u00e1n De Los Reyes Madrid Spain"},{"name":"European University of Madrid Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda del Carmen","family":"L\u00f3pez\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Albacete University Hospital Complex Albacete Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2987-5922","authenticated-orcid":false,"given":"Cristina","family":"Tejera","sequence":"additional","affiliation":[{"name":"Ferrol University Hospital Complex A Coru\u00f1a Spain"},{"name":"Epigenomics Group in Endocrinology and Nutrition, Epigenomics Unit, Health Research Institute of Santiago de Compostela (IDIS) University Hospital Complex of Santiago de Compostela Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"Bartual","sequence":"additional","affiliation":[{"name":"Valencia University Clinical Hospital Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Perea","sequence":"additional","affiliation":[{"name":"Mutua Terrassa University Hospital Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Jos\u00e9","family":"Pines","sequence":"additional","affiliation":[{"name":"Albacete University Hospital Complex Albacete Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-0903","authenticated-orcid":false,"given":"Antonio J.","family":"Amor","sequence":"additional","affiliation":[{"name":"Clinic Hospital Barcelona Spain"},{"name":"CIBERDEM, Biomedical Research Network Center for Diabetes and Associated Metabolic Diseases, Carlos III Health Institute (ISCIII) Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8670-6404","authenticated-orcid":false,"given":"\u00d3scar","family":"Moreno\u2010P\u00e9rez","sequence":"additional","affiliation":[{"name":"Dr. Balmis University General Hospital Alicante Spain"},{"name":"ISABIAL, Alicante Institute for Health and Biomedical Research Alicante Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-4431","authenticated-orcid":false,"given":"Rebeca","family":"Reyes\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Torrec\u00e1rdenas University Hospital Almer\u00eda Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema","family":"L\u00f3pez\u2010Gallardo","sequence":"additional","affiliation":[{"name":"Virgen del Rocio University Hospital Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Dur\u00e1n\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Getafe University Hospital Getafe Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Serrano","sequence":"additional","affiliation":[{"name":"Segovia General Hospital Segovia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"M\u00e1rquez\u2010Pardo","sequence":"additional","affiliation":[{"name":"Juan Ram\u00f3n Jim\u00e9nez University Hospital Huelva Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noem\u00ed","family":"Gonz\u00e1lez\u2010P\u00e9rez de Villar","sequence":"additional","affiliation":[{"name":"La Paz University Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Gargallo","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"Santos","sequence":"additional","affiliation":[{"name":"Burgos University Hospital Burgos Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Pujante","sequence":"additional","affiliation":[{"name":"Asturias Central University Hospital Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4307-8145","authenticated-orcid":false,"given":"Jessica","family":"Ares","sequence":"additional","affiliation":[{"name":"Asturias Central University Hospital Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Bellido","sequence":"additional","affiliation":[{"name":"Ferrol University Hospital Complex A Coru\u00f1a Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Conget","sequence":"additional","affiliation":[{"name":"Mutua Terrassa University Hospital Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0106-0091","authenticated-orcid":false,"given":"Fernando","family":"Gomez\u2010Peralta","sequence":"additional","affiliation":[{"name":"Segovia General Hospital Segovia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.2337\/dc19-2249","article-title":"A Patient\u2010Level Model to Estimate Lifetime Health Outcomes of Patients With Type 1 Diabetes","volume":"43","author":"Tran\u2010Duy A.","year":"2020","journal-title":"Diabetes Care"},{"issue":"5","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"686","DOI":"10.2337\/dc15-1990","article-title":"Intensive Diabetes Treatment and Cardiovascular Outcomes in Type 1 Diabetes: The DCCT\/EDIC Study 30\u2010Year Follow\u2010Up","volume":"39","author":"Diabetes Control and Complications Trial (DCCT)\/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group","year":"2016","journal-title":"Diabetes 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L.","year":"2025","journal-title":"World Journal of Diabetes"},{"issue":"1","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-025-19705-0","article-title":"The GMI\/HbA1c Ratio Does Not Independently Predict Diabetic Retinopathy in Adults With Type 1 Diabetes","volume":"15","author":"Sager\u2010La Ganga C.","year":"2025","journal-title":"Scientific Reports"},{"issue":"1","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s12933-025-02637-4","article-title":"Association Between the GMI\/HbA1c Ratio and Preclinical Carotid Atherosclerosis in Type 1 Diabetes: Impact of the Fast\u2010Glycator Phenotype Across Age Groups","volume":"24","author":"Puig\u2010Jov\u00e9 C.","year":"2025","journal-title":"Cardiovascular Diabetology"},{"issue":"3","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1111\/dom.70365","article-title":"CGM\u2010Derived Average Glucose Is More Strongly Associated With Microvascular Complications Than HbA1c in Type 1 Diabetes","volume":"28","author":"Stimson R. 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