دورية أكاديمية
The frequency of testing for glycated haemoglobin, HbA1c, is linked to the probability of achieving target levels in patients with suboptimally controlled diabetes mellitus.
| العنوان: | The frequency of testing for glycated haemoglobin, HbA1c, is linked to the probability of achieving target levels in patients with suboptimally controlled diabetes mellitus. |
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| المؤلفون: | Duff CJ; Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent, Staffordshire, UK.; Institute for Applied Clinical Sciences, University of Keele, Stoke-on-Trent, Staffordshire, UK., Solis-Trapala I; Institute for Applied Clinical Sciences, University of Keele, Stoke-on-Trent, Staffordshire, UK., Driskell OJ; Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent, Staffordshire, UK.; Institute for Applied Clinical Sciences, University of Keele, Stoke-on-Trent, Staffordshire, UK., Holland D; The Benchmarking Partnership, Alsager, Cheshire, UK., Wright H; Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent, Staffordshire, UK., Waldron JL; Department of Clinical Biochemistry, Royal Wolverhampton NHS Trust, Wolverhampton, UK., Ford C; Department of Clinical Biochemistry, Royal Wolverhampton NHS Trust, Wolverhampton, UK., Scargill JJ; Department of Clinical Biochemistry, Salford Royal NHS Foundation Trust, Salford, UK., Tran M; Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent, Staffordshire, UK., Hanna FWF; Department of Diabetes and Endocrinology, University Hospital of North Midlands, Stoke-on-Trent, Staffordshire, UK.; Centre for Health and Development, Staffordshire University, Stoke-on-Trent, Staffordshire, UK., Pemberton RJ; Diabetes UK (North Staffordshire Branch), Porthill, Newcastle-under-Lyme, Staffordshire, UK., Heald A; The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK., Fryer AA; Department of Clinical Biochemistry, Keele University, Institute for Applied Clinical Sciences, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, Staffordshire ST4 6QG, UK. |
| المصدر: | Clinical chemistry and laboratory medicine [Clin Chem Lab Med] 2018 Dec 19; Vol. 57 (2), pp. 296-304. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Walter De Gruyter Country of Publication: Germany NLM ID: 9806306 Publication Model: Print Cited Medium: Internet ISSN: 1437-4331 (Electronic) Linking ISSN: 14346621 NLM ISO Abbreviation: Clin Chem Lab Med Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin ; New York : Walter De Gruyter, c1998- |
| مواضيع طبية MeSH: | Diabetes Mellitus, Type 2/*blood , Glycated Hemoglobin/*analysis, Adult ; Blood Glucose/analysis ; Female ; Humans ; Male ; Probability |
| مستخلص: | 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 HbA1c targets and on HbA1c changes over time. Methods Data on 20,690 adults with diabetes with a baseline HbA1c of >53 mmol/mol (7%) were extracted from Clinical Biochemistry Laboratory records at three UK hospitals. We examined the effect of HbA1c tests/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 HbA1c using 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 HbA1c levels 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 HbA1c targets 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 HbA1c monitoring frequency is being insufficiently recognised in diabetes management. |
| التعليقات: | Comment in: Clin Chem Lab Med. 2018 Dec 19;57(2):148-149. (PMID: 30465715) |
| فهرسة مساهمة: | Keywords: diabetes mellitus; glycaemic target; glycated haemoglobin; monitoring; test utilisation |
| المشرفين على المادة: | 0 (Blood Glucose) 0 (Glycated Hemoglobin A) |
| تواريخ الأحداث: | Date Created: 20181004 Date Completed: 20191028 Latest Revision: 20221207 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1515/cclm-2018-0503 |
| PMID: | 30281512 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1437-4331 |
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| DOI: | 10.1515/cclm-2018-0503 |