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Hba1c Type 2 Diabetes

For Type 2 Diabetes, Less Intensive Hba1c Goals Promise Less Harm

For Type 2 Diabetes, Less Intensive Hba1c Goals Promise Less Harm

For Professionals Research Updates Diabetes complications For Type 2 Diabetes, Less Intensive HbA1c Goals Promise Less Harm Need for intensive drug treatment to reduce hemoglobin A1C targets called into question by the American College of Physicians but defended by the leading endocrine-related organizations, placing clinicians in the middle of debate over T2D treatment. Nearly 1 in 10 Americansmore than 29 million personshave type 2 diabetes mellitus (T2D), which is a leading cause of morbidity and mortality in the US.1 Treatment has been focused on lowering blood glucose levels, specifically hemoglobin A1c, to a specific target level in order to minimize risks for cardiovascular, cerebrovascular, neurologic, ophthalmologic, and renal complications (among others). A growing body of evidence now indicates that reducing blood glucose levels, while beneficial in lowering risk of complications, is also associated with potential harms, additional patient burden, and potentially higher costs fornonpregnant adults.2 This update, 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, focuses solely on the benefits and harms of targeting lower versus higher HbA1c levels, and does not address specific medications or other populations with T2D.2 Intensive Treatment for Type 2 Diabetes Should be Replaced with Individualized Care The evidence-based analysis determined that the harms associated with intensive treatment with drugs to targets of < 7% could be greater than the benefits, Jack Ende, MD, President of ACP and the Schaeffer Professor of Medicine at the Perelman School of Medicine at The University of Pennsylvania, in Philadelphia, told Continue reading >>

Hemoglobin A1c (hba1c) Test For Diabetes

Hemoglobin A1c (hba1c) Test For Diabetes

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes. Hemoglobin is a protein found in red blood cells. It gives blood its red color, and it’s job is to carry oxygen throughout your body. The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher change of getting of diabetes. Levels of 6.5% or higher mean you have diabetes. The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. A combination of diet, exercise, and medication can bring your levels down. People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year. People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can Continue reading >>

American College Of Physicians Releases 4 Guidelines For Hba1c Targets In T2d

American College Of Physicians Releases 4 Guidelines For Hba1c Targets In T2d

American College of Physicians Releases 4 Guidelines for HbA1c Targets in T2D American College of Physicians Releases 4 Guidelines for HbA1c Targets in T2D Individuals with advanced age and lower life expectancy should be treated to reduce symptoms rather than strictly focusing on HbA1c level target. The American College of Physicians (ACP) has released 4 updated guidance statements regarding glycated hemoglobin A1c (HbA1c) targets for non-pregnant adult patients with type 2 diabetes (T2D), published online in the Annals of Internal Medicine. ACP's analysis of the evidence behind existing guidelines found that treatment with drugs to targets of 7 percent or less compared to targets of about 8 percent did not reduce deaths or macrovascular complications such as heart attack or stroke but did result in substantial harms, said Jack Ende, MD, MACP, president of ACP. The evidence shows that for most people with type 2 diabetes, achieving an A1C between 7 percent and 8 percent will best balance long-term benefits with harms such as low blood sugar, medication burden, and costs. Guidance Statement 1: Clinicians should create personalized goals for glycemic control in patients with type 2 diabetes. These goals should be based on clinician-patient discussion of benefits and harms of pharmacotherapy, patient preferences, the patient's general health and life expectancy, treatment burden, and costs of care. Guidance Statement 2: Clinicians should aim to help their patients with type 2 diabetes achieve an HbA1c level between 7% and 8%. Guidance Statement 3: If a patient with type 2 diabetes achieves an HbA1c level <6.5%, clinicians should consider de-intensifying pharmacologic therapy. Guidance Statement 4: In treating patients with type 2 diabetes, clinicians should aim to minimi Continue reading >>

Guide To Hba1c

Guide To Hba1c

Tweet HbA1c is a term commonly used in relation to diabetes. This guide explains what HbA1c is, how it differs from blood glucose levels and how it's used for diagnosing diabetes. What is HbA1c? The term HbA1c refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout your body, joins with glucose in the blood, becoming 'glycated'. By measuring glycated haemoglobin (HbA1c), clinicians are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months. For people with diabetes this is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications. HbA1c is also referred to as haemoglobin A1c or simply A1c. HbA1c refers to glycated haemoglobin (A1c), which identifies average plasma glucose concentration. How does HBA1c return an accurate average measurement of average blood glucose? When the body processes sugar, glucose in the bloodstream naturally attaches to haemoglobin. The amount of glucose that combines with this protein is directly proportional to the total amount of sugar that is in your system at that time. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why peop Continue reading >>

Acp Update: Hba1c Targets For Glycemic Control In Type 2 Diabetes

Acp Update: Hba1c Targets For Glycemic Control In Type 2 Diabetes

ACP Update: HbA1c Targets for Glycemic Control in Type 2 Diabetes ACP Update: HbA1c Targets for Glycemic Control in Type 2 Diabetes Clinicians should personalize glycemic control goals; aim for HbA1c of 7 to 8% for most adults. (HealthDay News) -- Guidance has been developed for hemoglobin A1c (HbA1c) targets for glycemic control among nonpregnant adults with type 2 diabetes; the guidance statement was published online in the Annals of Internal Medicine. Amir Qaseem, MD, PhD, from the American College of Physicians in Philadelphia, and colleagues reviewed and evaluated guidelines that addressed HbA1c targets for treating type 2 diabetes in nonpregnant outpatient adults. The authors developed four guidance statements relating to HbA1c targets. For patients with type 2 diabetes, clinicians should personalize goals for glycemic control based on discussion of benefits and harms of pharmacotherapy, patient preference, patient general health and life expectancy, treatment burden, and costs of care. In most patients with type 2 diabetes, clinicians should aim to achieve an HbA1c level of between 7 to 8%. In patients with type 2 diabetes who achieve HbA1c levels below 6.5%, clinicians should consider deintensifying pharmacologic therapy. In patients with a life expectancy of less than 10 years due to advanced age, residence in a nursing home, or chronic conditions, clinicians should focus treatment on minimizing hyperglycemia-related symptoms and avoid targeting an HbA1c level because the harms outweigh the benefits in this population. "This statement focuses on the benefits and harms of targeting lower versus higher HbA1c levels and does not cover use of specific medications outside of their use to achieve HbA1c target," the authors write. One author disclosed financial ties Continue reading >>

The Impact Of The Hba1c Level Of Type 2 Diabetics On The Structure Of Haemoglobin

The Impact Of The Hba1c Level Of Type 2 Diabetics On The Structure Of Haemoglobin

This study explores the impact of HbA1c levels on the structure of haemoglobin (Hb) in patients with type 2 diabetes. Seventy-four diabetic patients were classified into the following two groups based on their level of HbA1c: group A, patients with good glycaemic control (HbA1c < 7.0%, n = 36); group B, patients with persistent hyperglycaemia (HbA1c ≥ 9.0%, n = 38). Thirty-four healthy people served as controls (group H). Hb structure was examined by Fourier transform infrared spectroscopy (FTIR), and diabetic erythrocytes were modelled to estimate the impact of glucose on these cells and Hb. Increasing glucose concentrations altered both erythrocyte parameters and the Hb secondary structure. Group B differed significantly from group H (p < 0.05): in the former, the ordered Hb secondary structure had a strong tendency to transform into a disordered secondary structure, decreasing structural stability. We presumed here that high HbA1c levels might be a factor contributing to Hb structural modifications in diabetic patients. FTIR spectral analysis can provide a novel way to investigate the pathogenesis of type 2 diabetes mellitus. Although the pathogenesis of type 2 diabetes mellitus is unclear, the increasing prevalence of this disorder is of great concern and constitutes a global public health crisis. HbA1c is the gold standard for evaluating the long-term glycaemic control of diabetic patients because it accurately reflects real glycaemic levels in vivo1,2. The American Diabetes Association (ADA) treatment guidelines suggest an HbA1c level <7.0% as the primary glycaemic control target for diabetics3, and a decrease in HbA1c level reduces the prevalence of chronic complications due to the disease4. Monnier et al.5 found the concentration of products of oxidative stres Continue reading >>

Type 2 Diabetes - Getting Diagnosed - Nhs.uk

Type 2 Diabetes - Getting Diagnosed - Nhs.uk

Type 2 diabetes is often diagnosed following blood or urine tests for something else. However, you should see your GP straight away if you have any symptoms of diabetes . To find out if you have type 2 diabetes, you usually have to go through the following steps: Your GP will check your urine and arrange a blood test to check your blood sugar levels. It usually takes about 1 to 2 days for the results to come back. If you have diabetes, your GP will ask you to come in again so they can explain the test results and what will happen next. What your GP will discuss with you during your appointment depends on the diagnosis and the treatment they recommend. what high blood sugar means for your health your lifestyle for example, alcohol and smoking Your GP will do their best to discuss the diagnosis with you, but this first appointment might only be 10 to 15 minutes. If you have questions about your diagnosis It's usually difficult to take in everything the GP tells you during the appointment. Talk to family and friends about what the GP told you, and write down any questions you have. Then make another GP appointment and take your list of questions with you. There's also a lot of information on diabetes available. Usually, the following things happen after your diagnosis: Your GP will prescribe medication . It might take time for you to get used to the medication and to find the right doses for you. Continue reading >>

Recent Hba1c Values And Mortality Risk In Type 2 Diabetes. Population-based Case-control Study

Recent Hba1c Values And Mortality Risk In Type 2 Diabetes. Population-based Case-control Study

Abstract This study aimed to evaluate mortality within 365 days of HbA1c values of <6.5% or >9.0% in participants with clinical type 2 diabetes mellitus. A matched nested case-control study was implemented, within a cohort of participants with type 2 diabetes from 2000 to 2008. Conditional logistic regression was used to model the odds ratio for mortality adjusting for comorbidity and drug utilisation. There were 97,450 participants with type 2 diabetes; 16,585 cases that died during follow up were matched to 16,585 controls. The most recent HbA1c value was <6.5% (48 mmol/mol) for 22.2% of cases and 24.2% of controls, the HbA1c was >9.0% for 9.0% of cases and 7.7% of controls. In a complete case analysis, the adjusted odds ratio (AOR) for mortality associated with most recent HbA1c <6.5% was 1.31 (95% confidence interval (CI): 1.21,1.42). After multiple imputation of missing HbA1c values the AOR was 1.20 (CI: 1.12,1.28). The complete case analysis gave an AOR for HbA1c >9.0% of 1.51 (CI: 1.33, 1.70), in the multiple imputation analysis this was 1.29 (1.17,1.41). The risk associated with HbA1c <6.5% was age dependent. In the multiple imputation analysis the AOR was 1.53 (CI: 0.84 to 2.79) at age<55 years but 1.04 (CI: 0.92, 1.17) at age 85 years and over. In non-randomised data, values of HbA1c that are either <6.5% or >9.0% may be associated with increased mortality within one year in clinical type 2 diabetes. Relative risks may be higher at younger ages. Figures Citation: Nicholas J, Charlton J, Dregan A, Gulliford MC (2013) Recent HbA1c Values and Mortality Risk in Type 2 Diabetes. Population-Based Case-Control Study. PLoS ONE 8(7): e68008. Editor: Heiner K. Berthold, Charité University Medicine Berlin, Germany Received: February 14, 2013; Accepted: May 24, 2013; Pub Continue reading >>

New Type 2 Diabetes Guideline Recommends More Moderate Hba1c Target

New Type 2 Diabetes Guideline Recommends More Moderate Hba1c Target

New type 2 diabetes guideline recommends more moderate HbA1c target New type 2 diabetes guideline recommends more moderate HbA1c target The American College of Physicians (ACP) has developed guidance recommendation statements for clinicians in selecting targets for the pharmacologic treatment of type 2 diabetes , as published in the Annals of Internal Medicine. The Clinical Guidelines Committee of the ACP, led by Amir Qaseem, MD, PhD, MHA, analyzed national guidelines that addressed hemoglobin A1c (HbA1c) targets for treating type 2 diabetes in nonpregnant outpatient adults. Based on its review, the ACP recommends that patients with type 2 diabetes should be treated to achieve an A1C between 7% and 8%, rather than 6.5% to 7%. ACP's analysis of the evidence behind existing guidelines found that treatment with drugs to targets of 7% or less compared to targets of about 8% did not reduce deaths or macrovascular complications such as heart attack or stroke but did result in substantial harms, stated Jack Ende, MD, president of the ACP. The evidence shows that for most people with type 2 diabetes, achieving an A1C between 7% and 8% will best balance long-term benefits with harms such as low blood sugar, medication burden, and costs. A summary of the guidelines is as follows: Clinicians should personalize goals for glycemic control in patients with type 2 diabetes on the basis of a discussion of benefits and harms of pharmacotherapy, patients' preferences, patients' general health and life expectancy, treatment burden, and costs of care. Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes. Clinicians should consider deintensifying pharmacologic therapy in patients with type 2 diabetes who achieve HbA1c levels less than 6.5% Continue reading >>

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin (a blood pigment that carries oxygen) that is bound to glucose. The blood test for HbA1c level is routinely performed in people with type 1 and type 2 diabetes mellitus. Blood HbA1c levels are reflective of how well diabetes is controlled. The normal range for level for hemoglobin A1c is less than 6%. HbA1c also is known as glycosylated, or glycated hemoglobin. HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose. High HbA1c levels indicate poorer control of diabetes than levels in the normal range. HbA1c is typically measured to determine how well a type 1 or type 2 diabetes treatment plan (including medications, exercise, or dietary changes) is working. How Is Hemoglobin A1c Measured? The test for hemoglobin A1c depends on the chemical (electrical) charge on the molecule of HbA1c, which differs from the charges on the other components of hemoglobin. The molecule of HbA1c also differs in size from the other components. HbA1c may be separated by charge and size from the other hemoglobin A components in blood by a procedure called high pressure (or performance) liquid chromatography (HPLC). HPLC separates mixtures (for example, blood) into its various components by adding the mixtures to special liquids and passing them under pressure through columns filled with a material that separates the mixture into its different component molecules. HbA1c testing is done on a blood sample. Because HbA1c is not affected by short-term fluctuations in blood glucose concentrations, for example, due to meals, blood can be drawn for HbA1c testing without regard to when food was eaten. Fasting for the blood test is not necessary. What Are Continue reading >>

Hba1c Targets In People With Type 2 Diabetes - Do They Matter?

Hba1c Targets In People With Type 2 Diabetes - Do They Matter?

Maintaining good glycaemic control reduces the risk of microvascular complications of type 2 diabetes and may also reduce the risk of some macrovascular complications. HbA1c targets should be individualised. Very intensive glycaemic control may be appropriate for some individuals but it is associated with increased risks with some evidence suggesting an increased risk of mortality. View / Download pdf version of this article Key concepts: A target HbA1c should be negotiated individually, but a level of close to 7% (53 mmol/mol) seems to be an acceptable compromise for the majority of people with type 2 diabetes Good glycaemic control reduces the risk of microvascular complications and may also reduce the risk of some macrovascular complications of type 2 diabetes Very intensive glycaemic control is associated with increased risks e.g. hypoglycaemia, weight gain and possibly increased risk of mortality Hyperglycaemia should not be treated in isolation when attempting to reduce cardiovascular risk Older people with longer duration of diabetes and who are at high cardiovascular risk may be at particular risk of harm from intensive control Early intervention is beneficial The emphasis of most diabetes management guidelines was, until recently, “the lower the HbA1c the better”. The results of several major recent studies have generated much discussion in the literature about what a target HbA1c should be, how tight intensive glycaemic control should be and which people are most likely to benefit from intensive control. Should this recent research alter the management of people with type 2 diabetes in primary care? What is the current recommended HbA1c target? Comparison of HbA1c units Percentage units (%) Molar units (mmol/mol) 6.0 42 6.5 48 7.0 53 7.5 59 8.0 64 8.5 69 9 Continue reading >>

Acp Recommends Less-intensive Hba1c Target For T2d

Acp Recommends Less-intensive Hba1c Target For T2d

ACP Recommends Less-Intensive HbA1c Target for T2D No proof of benefit for targets below 7%, new guidelines say by Jeff Minerd Jeff Minerd, Contributing Writer, MedPage Today This article is a collaboration between MedPage Today and: New type 2 diabetes guidelines from the American College of Physicians (ACP) recommend less-intensive blood sugar control for most patients, and suggest a target glycated hemoglobin (HbA1c) level between 7% and 8% for most patients. Note that studies have not consistently shown that intensive glycemic control to HbA1c levels below 7% reduces clinical microvascular events, or reduces macrovascular events and death. New type 2 diabetes guidelines from the American College of Physicians (ACP) recommend less-intensive blood sugar control for most patients, with a glycated hemoglobin (HbA1c) target between 7% and 8%. "Studies have not consistently shown that intensive glycemic control to HbA1c levels below 7% reduces clinical microvascular events, such as loss or impairment of vision, end-stage renal disease, or painful neuropathy, or reduces macrovascular events and death," said first author Amir Qaseem, MD, PhD, ACP vice president for clinical policy, and colleagues. To develop the new recommendations, the authors evaluated six sets of current guidelines from other organizations and reviewed five important clinical trials on which those guidelines are based. The updated guidance, published online in Annals of Internal Medicine , offers four key statements: Statement 1: Clinicians should personalize goals for glycemic control in patients with type 2 diabetes on the basis of a discussion of the benefits and harms of pharmacotherapy, patients' preferences, patients' general health and life expectancy, treatment burden, and costs of care Statemen Continue reading >>

Acp Calls For Moderate Glycemic Control In Type 2 Diabetes

Acp Calls For Moderate Glycemic Control In Type 2 Diabetes

ACP Calls for Moderate Glycemic Control in Type 2 Diabetes On March 6, the American College of Physicians (ACP) published new evidence-based guidance statements in Annals of Internal Medicine(annals.org) that focus on loosening glycemic control targets. The ACP recommended patients with type 2 diabetes be treated to achieve a hemoglobin A1c (HbA1c) level between 7 percent and 8 percent rather than the widely accepted range of 6.5 percent to 7 percent. "ACP's analysis of the evidence behind existing guidelines found that treatment with drugs to targets of 7 percent or less compared to targets of about 8 percent did not reduce deaths or macrovascular complications such as heart attack or stroke but did result in substantial harms," said ACP President Jack Ende, M.D., in a news release.(www.acponline.org) "The evidence shows that for most people with type 2 diabetes, achieving an A1c between 7 percent and 8 percent will best balance long-term benefits with harms such as low blood sugar, medication burden and costs." On March 6, the American College of Physicians (ACP) published new evidence-based guidance statements in Annals of Internal Medicine on loosening glycemic control targets. The ACP recommended patients with type 2 diabetes be treated to achieve a hemoglobin A1c between 7 percent and 8 percent rather than the widely accepted range of 6.5 percent to 7 percent. The ACP also released three other guidance statements on selecting targets for pharmacologic treatment of type 2 diabetes. Noting the policy implications of its recommendations, the ACP suggested that any physician performance measures developed to evaluate quality of care should not have a target HbA1c level below 8 percent for any patient population and should not have any HbA1c targets for elderly adults Continue reading >>

Testing For Diabetes: What Your Hba1c Levels Mean

Testing For Diabetes: What Your Hba1c Levels Mean

Testing for diabetes: what your HbA1c levels mean The test for Type 2 diabetes is quick and easyCredit:Tom Merton The basic tests to diagnose Type 2 diabetes are effective and very fast. However, often the illness is first diagnosed by chance, when a patient is being tested for something else. That was certainly true for 48-year-old Stacy Evans, a father of three, who works in sales in Milton Keynes. Evans, whose partner Debbie Barks, 51, works for the NHS, says: In 2012, I went to register with a new GP and had a urine test as part of the process. I didnt know anything about type 2 diabetes so wasnt then aware of having any symptoms. But my blood sugar readings were off the scale, apparently. "As I learnt about the disease, I realised that not only was I at high risk, as I was massively overweight and unfit, but also I was exhibiting classic symptoms. I needed to go to the toilet three or four times a night, for example. Other symptoms include a constant thirst, weight loss and excessive tiredness. Stacy Evans, 48, was diagnosed with Type 2 diabetes in 2012Credit:Rii Schroer/The Telegraph Evans was so unaware of what type 2 diabetes meant he wasnt even shocked. I had no idea how serious it could be. He later learnt that the condition which occurs when the body is unable to produce enough insulin or unable to use what insulin it does produce to control blood sugar levels can have serious consequences, including organ damage and coma. Healthy blood sugar levels from a diabetes test should be between 4.0 to 6.0 mmol/L (millimoles per litre) when fasting or up to 7.8 mmol/L two hours after eating a meal, according to the NHS. But when doctors took Evanss blood, they calculated his blood sugar levels at 17mmol/l. Evans was immediately put on to medication that makes the bo Continue reading >>

Hba1c And The Prediction Of Type 2 Diabetes In Children And Adults.

Hba1c And The Prediction Of Type 2 Diabetes In Children And Adults.

HbA1c and the Prediction of Type 2 Diabetes in Children and Adults. Vijayakumar P, et al. Diabetes Care. 2017. Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ. Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ [email protected] Diabetes Care. 2017 Jan;40(1):16-21. doi: 10.2337/dc16-1358. Epub 2016 Nov 3. OBJECTIVE: Long-term data validating glycated hemoglobin (HbA1c) in assessing the risk of type 2 diabetes in children are limited. HbA1c, fasting plasma glucose (FPG), and 2-h postload plasma glucose (2hPG) concentrations were measured in a longitudinal study of American Indians to determine their utility in predicting incident diabetes, all of which is thought to be type 2 in this population. RESEARCH DESIGN AND METHODS: Incident diabetes (FPG 126 mg/dL [7.0 mmol/L], 2hPG 200 mg/dL [11.1 mmol/L], HbA1c 6.5% [8 mmol/mol], or clinical diagnosis) was determined in 2,095 children without diabetes ages 10-19 years monitored through age 39, and in 2,005 adults ages 20-39 monitored through age 59. Areas under the receiver operating characteristic (ROC) curve for HbA1c, FPG, and 2hPG in predicting diabetes within 10 years were compared. RESULTS: During long-term follow-up of children and adolescents who did not initially have diabetes, the incidence rate of subsequent diabetes was fourfold (in boys) as high and more than sevenfold (in girls) as high in those with HbA1c 5.7% as in those with HbA1c 5.3%-greater rate ratios than experienced by adults in the same HbA1c categories. Analyses of ROCs revealed no significant differences between HbA1c, FPG Continue reading >>

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