Do Patient Characteristics Impact Decisions by Clinicians on Hemoglobin A 1c Targets?

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Do Patient Characteristics Impact Decisions by Clinicians on Hemoglobin A1c Targets?

In setting hemoglobin A1c (HbA1c) targets, physicians must consider individualized risks and benefits of tight glycemic control (1,2) by recognizing that the risk-benefit ratio may become unfavorable in certain patients, including the elderly and/or those with multiple comorbidities (3,4). Customization of treatment goals based on patient characteristics is poorly understood, partly due to insu...

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Comment on Shahraz et al. Do Patient Characteristics Impact Decisions by Clinicians on Hemoglobin A1c Targets? Diabetes Care 2016;38:e145-e146.

We have read with great interest the analysis by Shahraz et al. (1) regarding the impact of patient characteristics on HbA1c targets. In recent years, it has been recognized that ameliorating hyperglycemia does not lead to reduced mortality and improved cardiovascular outcomes in the short term. Therefore, the means whereby glucose is controlled and the “cost” of control (i.e., hypoglycemia and...

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Response to Comment on Shahraz et al. Do Patient Characteristics Impact Decisions by Clinicians on Hemoglobin A1c Targets? Diabetes Care 2016;38: e145-e146.

We have read with interest the study by Cahn et al. (1) that summarized the results on the salient determinants of setting glycemic targets by a large group of worldwide diabetologists. The authors showed that life expectancy and the risk of developing hypoglycemia are the two most important factors guiding decisions on individualized targets of HbA1c (1). The results of this study provide a mo...

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A patient with undetectable hemoglobin A(1c).

A blood sample from a 39-year-old female patient with newly diagnosed type 2 diabetes was assayed for hemoglobin (Hb) A1c on a Bio-Rad D10 HPLC platform. No peak for A1c was seen on the chromatogram (Fig. 1A), and the result was reported as 0%. A complete blood count was clinically significant for an Hb concentration of 10.9 g/dL (reference interval 12–15 g/dL) and a mean corpuscular volume of ...

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Incidental findings of variant hemoglobin during hemoglobin A(1c) testing.

A variant hemoglobin fraction may be an incidental finding during HbA(1c) analysis using the G8 Tosoh HPLC analyzer, but it is unclear if the retention times and fraction patterns can reliably predict the findings of a high-performance liquid chromatography (HPLC) β-thalassemia program (Bio Rad Variant II analyzer). We chose 100 samples sent for HbA(1c) determinations (G8 Tosoh) with an inciden...

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ژورنال

عنوان ژورنال: Diabetes Care

سال: 2016

ISSN: 0149-5992,1935-5548

DOI: 10.2337/dc16-0532