Q-Score: A composite metric for monitoring glycemic control after therapeutic intervention

Background and aims: Q-Score is a single-number composite metric for analysis of short-term glycemic control. Q-Score rises with worsening of glycemic quality recorded by continuous glucose monitoring (CGM). Here, we evaluated the suitability of Q-Score for screening of therapeutic effects.

Methods: Q-Score components are central glycemic tendency [mean sensor glucose, MSG (mmol/l)], hyperglycemia [time above range, TAR (h)], hypoglycemia [time below range, TBR (h)], intra- (Range, mmol/l) and inter-daily (MODD, mmol/l) variability. CGM-profiles were from a non-interventional, retrospective cross-sectional study. 212 people with diabetes mellitus using intermitted CGM were enrolled to investigate Q-Score at admission vs. discharge of inpatient diabetes care. Based on correlation analysis with a Q-Score=10 and TIR=70% as the limits for sufficient glycemic control (2; 5; 7), MSG > 9 mmol/L, range > 9 mmol/L and MODD > 2.5 mmol/L were defined to be above target.

Results: During inpatient diabetes care Q-Score decreased significantly (p<0.001) from 15.5 to 11.8 in people with type 1 (n=115 T1) and from 11.9 to 8.4 in people with type 2 (n=97 T2) diabetes, respectively. The highest decrease was seen in participants with Q-Score > 15 indicating dependency from baseline level. In people with type 1 and type 2 diabetes the Q-Score components central glycemic tendency (MSG: T1 ∆ -1.9; T2 ∆ -2.1 mmol/L), hyperglycemia (TAR: T1 ∆ -3.2; T2 ∆ -4.9 h), intra- (Range: T1 ∆ -1.9, T2 ∆ -1.4 mmol/L) and inter-daily (MODD: T1 ∆ -1.0, T2 ∆ -0.7 mmol/L) variability decreased significantly (p<0.001). Glucose management indicator (GMI%) and glycemic risk index (GRI) decreased in people with type 1 (GMI: ∆ -1.2%, GRI: -19.7) and type 2 (GMI: ∆ -1.3%; GRI: -23) diabetes, respectively. TIR increased from 52 to 65% in people with type 1 and from 57 to 77% in people with type 2 diabetes, respectively. The number of Q-Score components above target decreased from admission vs. discharge (T1 3.4 vs 2.5; T2 2.2 vs. 1.1).

Conclusion: Q-Score is a suitable metric for assessment of therapeutic effects on short-term glycemic control in people with type 1 and type 2 diabetes.

Publikationsverlauf

Artikel online veröffentlicht:
18. April 2024