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.
Part 5. Should Glycemic Goals Be the Same for All Patients?30/09/2010 Duration: 404h00s
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?30/09/2010 Duration: 79h00s
Dr. Bloomgarden briefly synopsizes laboratory test variability with regard to measuring HbA1c levels.
Part 3. Should HbA1c Be Used in the Diagnosis of T2DM?30/09/2010 Duration: 199h00s
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?30/09/2010 Duration: 528h00s
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?30/09/2010 Duration: 268h00s
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.