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Does daily monitoring of blood glucose predict hemoglobin A1c levels? (Clinical inquiries: from the family practice inquiries network).
* EVIDENCE-BASED ANSWER
Hemoglobin A1c (HbA1c) levels correlate closely, though not perfectly, with blood glucose levels in patients with diabetes (strength of recommendation [SOR]: A, based on systematic reviews).
Correlation is higher for blood glucose levels later in the day than earlier in the day, higher for blood glucose levels in the most recent 30 days than from the prior 31-120 days, and higher for patients with type 2 diabetes compared with patients with type 1 diabetes (SOR: A, based on cohort studies).
* EVIDENCE SUMMARY
Four cohort studies of patients with diabetes have compared overall mean blood glucose levels with HbA1c levels. (1-4) All but one (4) were limited to patients with type 1 diabetes. Study periods ranged from i to 6 months, and frequency of blood glucose measurement ranged from 2 to 4 times per day.
Correlation coefficients between mean blood glucose levels and HbA1c levels ranged from 0.71 to 0.86, implying that 50% to 74% of the variance in HbA1c is explained by the mean blood glucose (in each study, correlation was significant [P<.02]).
We found 5 studies comparing blood glucose measurements at specific times of day with HbA1c levels (see Table). Data from 3 studies comparing blood glucose values after lunchtime with those earlier in the day suggest that the lunchtime levels are more closely associated with HbA1c levels. (5,7,9) No consistent difference was shown between preprandial and postprandial blood glucose…
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