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Hemoglobin A1c Compared with Three Conventional Measures of Diabetes Control

  1. Marc H Blanc,
  2. Donald M Barnett,
  3. Ray E Gleason,
  4. Peter J Dunn and
  5. J Stuart Soeldner
  1. E. P. Joslin Research Laboratory, Department of Medicine, Peter Bent Brigham Hospital and Harvard Medical School; the New England Deaconess Hospital; and the Joslin Diabetes Foundation, Inc Boston, Massachusetts
  1. Address reprint requests to J. Stuart Soeldner, E. P. Joslin Research Laboratory, One Joslin Place, Boston, Massachusetts 02215.

Abstract

Control of diabetes was studied during an 8-wk camp program in 18 insulin-dependent counselors with a mean age of 19.3 yr and a mean duration of diabetes of 11.4 yr. A composite score was obtained for each subject derived from three factors: percent sugar-free urine tests, 24-h glucose excretion as percent of carbohydrate intake, and mean preprandial blood glucose (MPBG). The mean hemoglobin A1c (HbA1c) at the end of the period was 8.3 ± 1.6% (± SD) (normal range, 4–6%). Scores ranging from 24 (fair control) to 45 (excellent control) showed a significant inverse correlation with HbA1c (r = – 0.807, P < 0.001) and MPBG (r = – −0.674, P < 0.01). HbA1c showed a significant correlation with the MPBG (r = 0.693, P < 0.01). The HbA1c level was predicted better by percent sugar-free urine tests than by the 24-h glucose excretion. Thus it appears that accurate quantification of control may be obtained by using a scoring system. Critical comparison of HbA1c levels to various glycemic indices may provide useful alternatives for estimating diabetes control.

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