Brief Commentary: Laboratory Accuracy of Hemoglobin A<sub>1c</sub> Ranges and Treatment Targets for Patients With Type 2 Diabetes
Authors: Brian V. Burke, Sandra Hedin
Journal: Annals of Internal Medicine (2018)

Ideas and Opinions21 August 2018Brief Commentary: Laboratory Accuracy of Hemoglobin A1c Ranges and Treatment Targets for Patients With Type 2 DiabetesBrian V. Burke, MD and Sandra Hedin, PharmDBrian V. Burke, MDDayton VA Medical Center, Dayton, Ohio (B.V.B.)Search for more papers by this author and Sandra Hedin, PharmDEdward Hines Jr. VA Hospital, Hines, Illinois (S.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1482 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Editors' Note: This commentary was selected for publication from among several submitted in response to a call for readers' perspectives on treatment targets for type 2 diabetes.Although major guidelines generally agree that hemoglobin A1c (HbA1c) targets should be modified on the basis of various clinical factors, they disagree on glycemic targets. We suggest that 2 factors contribute to this disagreement: First, not all guideline committees have evaluated evidence regarding the laboratory accuracy of the HbA1c test. Second, not all guideline committees have assessed whether racial differences exist. The American College of Physicians, in developing its guidance statement (1), did not ...References1. Qaseem A, Wilt TJ, Kansagara D, Horwitch C, Barry MJ, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Hemoglobin A1c targets for glycemic control with pharmacologic therapy for nonpregnant adults with type 2 diabetes mellitus: a guidance statement update from the American College of Physicians. Ann Intern Med. 2018;168:569-576. [PMID: 29507945]. doi:10.7326/M17-0939 LinkGoogle Scholar2. American Diabetes Association. 6. Glycemic targets: standards of medical care in diabetes 2018. Diabetes Care. 2018;41 Suppl 1 S55-64. CrossrefMedlineGoogle Scholar3. Conlin PR, Colburn J, Aron D, Pries RM, Tschanz MP, Pogach L. Synopsis of the 2017 U.S. Department of Veterans Affairs/U.S. Department of Defense clinical practice guideline: management of type 2 diabetes mellitus. Ann Intern Med. 2017;167:655-63. [PMID: 29059687]. doi:10.7326/M17-1362 LinkGoogle Scholar4. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes & prediabetes tests. 2018. Accessed at https://niddk.nih.gov/health-information/diagnostic-tests/diabetes-prediabeteson 25 April 2018. Google Scholar Author, Article, and Disclosure InformationAffiliations: Dayton VA Medical Center, Dayton, Ohio (B.V.B.)Edward Hines Jr. VA Hospital, Hines, Illinois (S.H.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1482.Corresponding Author: Brian V. Burke, MD, Dayton VA Medical Center, 4100 West 3rd Street, Routing #11C, Dayton, OH 45428; e-mail, brian.[email protected]gov.Current Author Addresses: Dr. Burke: 4100 West 3rd Street, Routing #11C, Dayton, OH 45419.Dr. Hedin: 5000 South 5th Street, Pharmacy 119, Hines, IL 60141.Author Contributions: Drafting of the article: B.V. Burke, S. Hedin.Final approval of the article: B.V. Burke, S. Hedin.This article was published at Annals.org on 26 June 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBrief Commentary: The Glycemic Target Guideline Controversy: Same Evidence, Different Perspectives, and a Proposal for Common Ground David C. Aron , Paul R. Conlin , and Leonard Pogach Brief Commentary: Confusing Treatment Guidelines for Patients With Type 2 Diabetes Irl B. Hirsch and Jay S. Skyler Brief Commentary: Social Determinants of Health and Treatment Targets for Type 2 Diabetes D.R. Bailey Miles Brief Commentary: Glycemic Targets for Older Adults With Type 2 Diabetes Emily B. Schroeder and Andrew J. Karter Metrics Cited byTo What Target Hemoglobin A1c Level Would You Treat This Patient With Type 2 Diabetes? Grand Rounds Discussion From Beth Israel Deaconess Medical CenterGerald W. Smetana, MD, David M. Nathan, MD, David C. Dugdale, MD, and Risa B. Burns, MD, MPH 21 August 2018Volume 169, Issue 4Page: 254-255KeywordsBloodClinical laboratoriesGlucoseGrading of Recommendations Assessment Development and EvaluationHbA1cHemoglobinRenal diseasesResearch laboratoriesTreatment guidelinesType 2 diabetes ePublished: 26 June 2018 Issue Published: 21 August 2018 PDF downloadLoading ...