Interpretation of Hemoglobin A1c (HbA1c) Values among Diabetic Patients

Abstract

Background: Few studies have examined patients’ views, knowledge, and understanding of glycohemoglobin A1c (HbA1c) testing. We explored such issues in patients with type 1 diabetes and used their statements to estimate analytical quality specifications for HbA1c testing. Methods: We recruited 201 patients from a hospital outpatient clinic. A questionnaire was used to collect information on diabetes characteristics, perceived knowledge of HbA1c, last HbA1c value, HbA1c target value, and thresholds for action. Patients were asked to indicate the magnitude of change in HbA1c from 9.4% that they would consider to be a true (real) change; from their responses, we calculated patient-derived quality specifications for HbA1c. Results: Fifty-eight percent of the patients felt they had “high” knowledge about HbA1c, and >80% of responders knew their last HbA1c value, their target HbA1c, and the threshold value of HbA1c for treatment intensification. The mean acceptable HbA1c value was 7.5%. Patients with lower values on their most recent tests reported lower target values for HbA1c and lower values for the upper HbA1c threshold for treatment intensification. An analytical CV (CVa) of 3.1% would be satisfactory for 75% of patients when HbA1c is increasing (80% confidence), and a CVa of 3.2% would be satisfactory for 75% when HbA1c is decreasing (95% confidence). Conclusions: Type 1 patients’ perceived knowledge about HbA1c testing is high. They are well informed about their own personal results and about target values and the upper HbA1c threshold for action. The patient-derived analytical quality specification for imprecision (CV) is 3.1%.

Association between glycemic control and the level of knowledge and disease awareness in type 2 diabetic patients

“…36 The inverse correlation between duration of diabetes and HbA 1c levels in our study is also in agreement with the results of other investigators. 37 HbA 1c levels are reduced with time as diabetic patients gain knowledge and personal experience in managing the disease. A significant positive correlation was detected between duration of diabetes and the KA score, which is particularly inter esting because no such correlation was found between age and the KA score or between age and HbA 1c levels.…”

A new complementary approach for oral health and diabetes management: health coaching

“…HbA1c can be defined as an objective measure for lifestyle behaviour change. Regular monitoring of HbA1c values which is measured in clinical settings is now the principal way to measure and track longterm glycaemic control objectively in diabetes 42 . Knowledge, attitude and motivation are the most important for the patients' ability to make behavioural changes to maintain or reduce HbA1c levels 42 .…”

“…Regular monitoring of HbA1c values which is measured in clinical settings is now the principal way to measure and track longterm glycaemic control objectively in diabetes 42 . Knowledge, attitude and motivation are the most important for the patients' ability to make behavioural changes to maintain or reduce HbA1c levels 42 . In the present study, the HC groups compared with the HE groups significantly enhanced their lifestyles in line with the significantly higher improvement in HbA1c.…”

“…The CPI was used to monitor the alterations of the periodontal treatment needs over the intervention period. WHO guidelines were followed for the measurement 38,39 : the index teeth in six sextants 11,16,17,26,30,35,36,[40][41][42] were probed and the highest score for each sextant was recorded. If no index teeth/tooth were present in a sextant qualifying for examination, at least two non-index remaining teeth in that sextant were examined and the highest score was recorded.…”

New Onset Diabetes after Transplantation [NODAT] Risks Factors Outcome and Possible Role of Diabetes Educators

“…Harwell et al [87] conducted a telephone survey in a rural population group and found that the participants knew their last A1C value, but they could not interpret the value properly. Skeie et al [88] found that the highknowledge group, that included individuals who had diabetes for a longer time period, had a better understanding of A1C compared to the low-knowledge group. Evidence shows that as an individual's knowledge of diabetes management increases the A1C values decrease.…”