Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A<sub>1c</sub> Levels
Authors: Richard M. Bergenstal, Robin L. Gal, Roy W. Beck
Journal: Annals of Internal Medicine (2018)

Letters6 February 2018Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c LevelsRichard M. Bergenstal, MD, Robin L. Gal, MSPH, and Roy W. Beck, MD, PhDRichard M. Bergenstal, MDInternational Diabetes Center at Park Nicollet, Minneapolis, Minnesota (R.M.B.), Robin L. Gal, MSPHJaeb Center for Health Research, Tampa, Florida (R.L.G., R.W.B.), and Roy W. Beck, MD, PhDJaeb Center for Health Research, Tampa, Florida (R.L.G., R.W.B.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0589 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Garg's comments about the conclusive nature of our study showing that, on average, HbA1c levels overestimate the mean glucose concentration in black persons compared with white persons. We agree with Dr. Garg's statement that HbA1c is the 1 glycemic metric shown to correlate with long-term diabetes complications. However, instead of urging caution in applying our data to clinical practice, we suggest that understanding the relationship between a person's HbA1c level and mean glucose concentration can actually help more safely and effectively guide clinical decision making.Our data indicate that HbA1c levels, regardless of race or ...Reference1. Beck RW, Connor CG, Mullen DM, Wesley DM, Bergenstal RM. The fallacy of average: how using HbA1c alone to assess glycemic control can be misleading. Diabetes Care. 2017;40:994-9. [PMID: 28733374] doi:10.2337/dc17-0636 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (R.M.B.)Jaeb Center for Health Research, Tampa, Florida (R.L.G., R.W.B.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2596. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRacial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels Richard M. Bergenstal , Robin L. Gal , Crystal G. Connor , Rose Gubitosi-Klug , Davida Kruger , Beth A. Olson , Steven M. Willi , Grazia Aleppo , Ruth S. Weinstock , Jamie Wood , Michael Rickels , Linda A. DiMeglio , Kathleen E. Bethin , Santica Marcovina , Andreana Tassopoulos , Sooji Lee , Elaine Massaro , Suzan Bzdick , Brian Ichihara , Eileen Markmann , Paul McGuigan , Stephanie Woerner , Michelle Ecker , Roy W. Beck , and Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels Rajesh Garg Metrics Cited byHbA1c and Glucose Management Indicator Discordance: A Real-World AnalysisEvaluation of Hemoglobin A1c before and after initiation of continuous glucose monitoring in children with type 1 diabetes mellitusHbA1c variability and long-term glycemic control are linked to diabetic retinopathy and glomerular filtration rate in patients with type 1 diabetes and multiethnic background 6 February 2018Volume 168, Issue 3Page: 232-233KeywordsAttentionDecision makingDisclosureGlucoseHbA1cHemoglobinPopulation statisticsRacial and ethnic issues ePublished: 6 February 2018 Issue Published: 6 February 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...