HbA1c Targets Not Individualized to Patients
HbA1c targets are not linked to patient variables including biological, physical, or mental health.
HealthDay News — Patient variables seem not to be associated with hemoglobin A1c (HbA1c) targets, according to a study published online in Diabetes Care.
Saeid Shahraz, MD, PhD, from Tufts Medical Center in Boston, and colleagues used data from the National Health and Nutrition Examination Survey to analyze patient-reported HbA1c targets set by physicians and whether there was a correlation between targets and patient characteristics. Data were included for 2,641 individuals with self-reported diabetes, of whom 1,782 responded to a question about HbA1c targets.
The researchers found that 54% of respondents reported a target; others reported that they did not know or that no target was set. Only 4% of the sample reported target HbA1c >7%. Of those reporting that a target was not set, 26% were older than 75 years. Of those who were not aware of their target, 70% were nonwhite. From 2005 to 2013 there was a decrease in the proportion responding that they did not know their target, from 30% to 10%. There were no correlations for variables representing demographics; medical history; biological, physical, and mental health; and health service use with reported target HbA1c.
"The lack of variation with patient characteristics suggests overreliance on a general approach, without consideration of individual variation in the risks and benefits (or patient preference) of tight control," the authors write.
- Shahraz S, Pittas AG, Lundquist CM, et al. Do Patient Characteristics Impact Decisions by Clinicians on Hemoglobin A1c Targets? Diabetes Care. 2016; doi: 10.2337/dc16-0532