E. Cagliero et al., Immediate feedback of HbA(1c) levels improves glycemic control in type I and insulin-treated type 2 diabetic patients, DIABET CARE, 22(11), 1999, pp. 1785-1789
OBJECTIVE - Accurate and reliable HbA(1c) results can be obtained at the ti
me of the office visit by using benchtop analyzers. We tested the hypothesi
s that immediately available HbA(1c) result; could improve glycemic control
by changing physician or patient behavior or both.
RESEARCH DESIGN AND METHODS- A randomized controlled trial was conducted in
201 type 1 and insulin-treated type 2 diabetic patients attending an acade
mic diabetes center. HbA(1c) levels, changes in insulin therapy, and use of
health care resources were assessed during a 12-month follow-up period.
RESULTS - HbA(1c) levels decreased significantly at 6 and 12 months in the
immediate assay group (-0,57 +/- 1.44 and -0.40 +/- 1.65%, respectively; P
< 0.01) but did not change in the control group (-0.11 +/- 0.79 and -0.19 /- 1.16%, respectively; NS). The changes were similar for both type 1 and t
ype 2 diabetic patients. There were no differences in the rates of hypoglyc
emic events or use of health care resources.
CONCLUSIONS - In the setting of a controlled randomized trial, the immediat
e feedback of HbA(1c) results at the time of patient encounters resulted in
a significant improvement of glycemic control at 6-month follow-up and per
sisted for the 12-month study . The introduction of this assay was positive
ly received by both patients and physicians.