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August 2016

Complications Correlated with High A1C Levels

By Samuel Kolodney 3 years ago 4953 Views No comments

The Diabetes Control and Complications Trial (DCCT) was a study that provided a definitive link between A1c levels and the risk of developing comorbidities commonly associated with diabetes. The results of the study depicted in the graph below chart the correlations of A1C levels for patients with type 1 diabetes. The graph displays the relative increased risk for retinopathy, nephropathy, and microalbuminuria, as A1C levels rise. It also displays an accelerated risk of retinopathy and nephropathy as A1c levels approach 12%. The study concluded that improved glycemic control can delay the onset of diabetic retinopathy, nephropathy and neuropathy and slow the progression of these disease states in patients with type 1 diabetes. [1]

Patients with type 1 diabetes (n=1,441)
Adapted from DCCT. Diabetes 1995;44:968-43.

A1C Now Standards of Care

By Samuel Kolodney 3 years ago 2334 Views No comments

HbA1c testing is a useful way to determine a patient’s average blood glucose level. The American Diabetes Association (ADA) recommends A1C testing to monitor a patient's ability to control their blood sugar. The A1c test should be performed quarterly on patients who are not meeting their target blood sugar levels. For patients who have diabetes and are meeting their glycemic targets, the A1c test should be performed semi-annually. The National Institute for Health and Clinical Excellence, American Diabetes Association and International Diabetes Federation, have published guidelines regarding the frequency of A1C testing, which are condensed in the chart below.

1. ADA Diabetes Care 2014; 37 (Suppl 1):S14-80
2. https://www.nice.org.uk/guidance/qs6
3. IDF,https://www.idf.org/component/attachments/attachments.html?id=725&task=download

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