Individualizing Target HbA1c Level

5 episodes - English - Latest episode: over 13 years ago -

Hemoglobin A1 (HbA1c) measurement is widely used in the management of type 2 diabetes mellitus (T2DM). However, expert consensus and professional guidelines conflict as to the correct use of this tool for diagnosis and therapeutic decision-making. In this podcast, Zachary Bloomgarden, MD, argues that a "one-size-fits-all" approach to interpretation and use of HbA1c is inherently flawed. He discusses the reasons and strategies for individualizing treatment goals and HbA1c targets in patients with T2DM.

Science type 2 diabetes mellitus t2dm ada guidelines glycemia hba1c hemoglobin a1c hypoglycemia glucose level blood sugar
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Episodes

Part 5. Should Glycemic Goals Be the Same for All Patients?

September 30, 2010 07:10 - 6 minutes - 404 Bytes

Dr. Bloomgarden reviews recent trial data (ie, ACCORD, ADVANCE, VA diabetes trial), and examines different safety issues that must be taken into account in determining how intensive a glycemic intervention be considered.

Part 4. Are There Methodologic Issues with Measuring HbA1c?

September 30, 2010 07:09 - 1 minute - 79 Bytes

Dr. Bloomgarden briefly synopsizes laboratory test variability with regard to measuring HbA1c levels.

Part 3. Should HbA1c Be Used in the Diagnosis of T2DM?

September 30, 2010 07:08 - 3 minutes - 199 Bytes

In Part 3 of this podcast, the discussion surrounds the International Expert Committee's recommendations, which has been taken up by the American Diabetes Association, to suggest that 6.5 be used for the diagnosis of diabetes. Dr. Bloomgarden offers his thoughts on the relationship of blood sugar and HbA1c and how it is affected by age, ethnicity, anemia, and other factors.

Part 2. Does HbA1c Provide a True Average Glucose Measurement with a High Degree of Accuracy in an Individual Patient?

September 30, 2010 07:07 - 8 minutes - 528 Bytes

Dr. Bloomgarden focuses on the various factors influencing A1c, and explores the issues surrounding a

Part 1. Has HbA1c Lowering Been Incorrectly Interpreted in Current Guidelines?

September 30, 2010 07:06 - 4 minutes - 268 Bytes

Zachary Bloomgarden, MD, discusses hemoglobin A1c (HbA1c) lowering with various drugs. In a meta-analysis done, Dr. Bloomgarden and colleagues found that there was a strong relationship between baseline glycemia and the degree of fallen blood sugar. He also touches on the concerns that the ADA guidelines make recommendations that may be flawed.