RANDOM BLOOD-GLUCOSE ESTIMATION IN TYPE-2 DIABETES - DOES IT REFLECT OVERALL GLYCEMIC CONTROL

The relationship between clinic-measured random blood glucose and glyc ated haemoglobin was investigated in 204 non-insulin-dependent diabeti c patients to determine the value of random blood glucose on managemen t decisions in these patients. Treatment was with diet alone in 104 pa tients (51 %: Group 1), and diet and oral hypoglycaemic agents in 100 patients (49 %: Group 2). Random blood glucose and glycated haemoglobi n were lower in Group 1 than Group 2 (10.9 +/- 4.0 vs 13.0 +/- 4.0 mmo l l-1, p < 0.001, and 8.5 (7.8-10.2) vs 9.6 (8.1-11.0) %, p < 0.01, re spectively), and there was a positive correlation between random blood glucose and glycated haemoglobin in both groups (r(Group1) = 0.76, an d r(Group2) = 0.54, both p < 0.001). In Group 1, 48 (46 %) patients ha d a random blood glucose < 10 mmol l-1 and all but 2 of these had a gl ycated haemoglobin of < 10 %. Thus, random blood glucose < 10 mmol l-1 was 96 % sensitive for glycated haemoglobin < 10 %. In Group 2 the sa me sensitivity was 92 %. These data suggest that clinic-measured rando m blood glucose levels below 10.0 mmol l-1 predict acceptable overall glycaemic control in non-insulin-dependent diabetic patients, particul arly in those on diet alone. However, a clinic-measured random blood g lucose above 10 mmol l-1 was of limited value in predicting glycated h aemoglobin values above 10 % and a blood glucose cut-off of 14 mmol l- 1 appeared more useful. Where resources are limited, clinic random blo od glucose estimation may allow clinicians to use glycated haemoglobin measurements more discriminately.