Change in hemoglobin A1c one year following the 2014 American Diabetes Association guideline update

Diabetes Research and Clinical Practice
G Todd AlonsoBrigitte Frohnert

Abstract

In June 2014, the American Diabetes Association lowered recommended hemoglobin A1c (HbA1c) targets from <8.5% (69mmol/mol) for children <6years of age and from <8.0% (64mmol/mol) for children 6-12years of age to <7.5% (58mmol/mol). Lower target HbA1c may lead to better glycemic control but could increase the risk of severe hypoglycemia. Patients with type 1 diabetes >1year duration, age 0-12years and seen in our center between January 1 and June 30, 2014 or between January 1 and June 30, 2015 were included. 1013 unique patients had 2684 encounters. We analyzed first quarterly HbA1c (January-March, April-June) and self-reported severe hypoglycemia at all clinic encounters. HbA1c across the age span and within the 0-<6, 6-12, and 0-12year old groups did not differ in the insurance adjusted mixed-effects model. Least squares means for all patients' HbA1c in 2014 was 8.59±0.04 (70±0.5mmol/mol); for 2015, 8.60±0.04 (70±0.5mmol/mol) (p=0.90). Severe hypoglycemia data fields were more complete in 2015 (43% vs 50%). Logistic regression adjusting for follow up showed no difference in severe hypoglycemia for all ages (p=0.80). HbA1c did not change 1year after the updated guidelines despite adoption of the new targets. Assessing changes i...Continue Reading

Related Concepts

Related Feeds

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.

Related Papers

Canadian Family Physician Médecin De Famille Canadien
G Michael AllanJacques Romney
Nihon rinsho. Japanese journal of clinical medicine
Makoto Tominaga
Pediatric Diabetes
Francine Ratner KaufmanPisit Pitukcheewanont
The Journal of the South Carolina Medical Association
Lisal FolsomKit Simpson
© 2022 Meta ULC. All rights reserved