TIME IN RANGE - NOT HBA1C - SHOULD GUIDE MOST DIABETES TREATMENT DECISIONS

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Clinicians should consider temporary continuous glucose monitoring for any person with diabetes to assess their time spent in the recommended glucose range as an effective guide for treatment decisions, according to a speaker. HbA1c may underestimate or overestimate a person’s glucose levels, does not reveal glycemic variability, and has limited utility for insulin dosing decisions, George Grunberger, MD, FACP, chairman of the Grunberger Diabetes Institute in Bloomfield Hills, Michigan, said during a presentation at the Heart in Diabetes CME Conference.

 

HbA1c is also unreliable for people with hemolytic anemia and iron deficiency and for those who are pregnant. HbA1c correlation with mean glucose can also vary among racial backgrounds. Time in range emerged as a prominent theme among diabetes experts as early as 2016, when the American Association of Clinical Endocrinology convened a consensus conference on CGM to determine new standard simple metrics that could inform therapy adjustment and “get away from HbA1c culture,” Grunberger said.

 

Source: Regina Schaffer, Endocrine Today [9/12/21]

Courtesy of Barry Block, editor of PM News

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