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The frequency of testing for glycated haemoglobin, $HbA_{1c}$, is linked to the probability of achieving target levels in patients with suboptimally controlled diabetes mellitus
| Content Provider | Scilit |
|---|---|
| Author | Duff, Christopher J. Solis-Trapala, Ivonne Driskell, Owen J. Holland, David Wright, Helen Waldron, Jenna L. Ford, Clare Scargill, Jonathan J. Tran, Martin Hanna, Fahmy W. F. Pemberton, R. John Heald, Adrian Fryer, Anthony A. |
| Copyright Year | 2018 |
| Abstract | Background: We previously showed, in patients with diabetes, that >50% of monitoring tests for glycated haemoglobin (HbA1c) are outside recommended intervals and that this is linked to diabetes control. Here, we examined the effect of tests/year on achievement of commonly utilised HbA1ctargets and on HbA1cchanges over time.Methods: Data on 20,690 adults with diabetes with a baseline HbA1cof >53 mmol/mol (7%) were extracted from Clinical Biochemistry Laboratory records at three UK hospitals. We examined the effect of HbA1ctests/year on (i) the probability of achieving targets of ≤53 mmol/mol (7%) and ≤48 mmol/mol (6.5%) in a year using multi-state modelling and (ii) the changes in mean HbA1cusing a linear mixed-effects model.Results: The probabilities of achieving ≤53 mmol/mol (7%) and ≤48 mmol/mol (6.5%) targets within 1 year were 0.20 (95% confidence interval: 0.19–0.21) and 0.10 (0.09–0.10), respectively. Compared with four tests/year, having one test or more than four tests/year were associated with lower likelihoods of achieving either target; two to three tests/year gave similar likelihoods to four tests/year. Mean HbA1clevels were higher in patients who had one test/year compared to those with four tests/year (mean difference: 2.64 mmol/mol [0.24%], p<0.001).Conclusions: We showed that ≥80% of patients with suboptimal control are not achieving commonly recommended HbA1ctargets within 1 year, highlighting the major challenge facing healthcare services. We also demonstrated that, although appropriate monitoring frequency is important, testing every 6 months is as effective as quarterly testing, supporting international recommendations. We suggest that the importance HbA1cmonitoring frequency is being insufficiently recognised in diabetes management. |
| Related Links | http://www.degruyter.com/downloadpdf/j/cclm.ahead-of-print/cclm-2018-0503/cclm-2018-0503.xml |
| Ending Page | 304 |
| Page Count | 9 |
| Starting Page | 296 |
| ISSN | 14346621 |
| e-ISSN | 14374331 |
| DOI | 10.1515/cclm-2018-0503 |
| Journal | Clinical Chemistry and Laboratory Medicine (CCLM) |
| Issue Number | 2 |
| Volume Number | 57 |
| Language | English |
| Publisher | Walter de Gruyter GmbH |
| Publisher Date | 2018-10-02 |
| Access Restriction | Open |
| Subject Keyword | Clinical Chemistry and Laboratory Medicine (cclm) Medical Laboratory Technology Diabetes Mellitus Glycaemic Target Glycated Haemoglobin Monitoring Test Utilisation Journal: Clinical Chemistry and Laboratory Medicine (CCLM), Issue- 10 |
| Content Type | Text |
| Resource Type | Article |
| Subject | Biochemistry (medical) Clinical Biochemistry |
