| Utility of immediate hemoglobin A1c in children with type I diabetes mellitus. | |
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MedLine Citation:
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PMID: 20070556 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: Immediate feedback (IFB) of hemoglobin A1c (HbA1c) results to adults with type 1 and 2 diabetes allows more appropriate care decisions at the clinic visit and may improve glycemic control. Our objective is to determine whether IFB of HbA1c results to children with type 1 diabetes will improve patient care and glycemic control. METHODS: In this prospective randomized controlled trial, children under 18 years of age were randomly assigned to receive HbA1c results during their diabetes clinic visit by point-of-care fingerstick testing (immediate) or several days after by venipuncture and laboratory assessment (conventional). HbA1c levels, therapy changes, and painfulness of testing were recorded at baseline and every follow-up appointment for a year. RESULTS: The 215 patients studied had similar baseline characteristics including initial HbA1c (7.90 ± 1.24% vs. 7.81 ± 1.13%, p = 0.25). IFB improved HbA1c at 3 months (-0.20 ± 0.66%, p = 0.005) with a return to baseline for the remainder of the study. Subjects receiving conventional feedback had increased HbA1c results at 12 months (+0.27 ± 1.05%, p = 0.048). Less frequent patient-clinician communication between visits was reported with IFB (0.29 ± 0.48 vs. 0.38 ± 0.49 contacts/visit, p = 0.043). Subjects rated fingersticks as less painful than conventional venipuncture (0.30 ± 0.66 vs. 3.9 ± 2.6, p < 0.001). CONCLUSIONS: IFB of HbA1c is a more acceptable method of HbA1c determination in children with type 1 diabetes mellitus. Although sustained improvements in glycemic control did not result from this intervention alone, IFB testing resulted in more efficient patient-clinician communication and was less painful. |
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Authors:
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Michael S D Agus; Jamin L Alexander; Joseph I Wolfsdorf |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric diabetes Volume: 11 ISSN: 1399-5448 ISO Abbreviation: Pediatr Diabetes Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100939345 Medline TA: Pediatr Diabetes Country: Denmark |
Other Details:
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Languages: eng Pagination: 450-4 Citation Subset: IM |
Copyright Information:
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© 2010 John Wiley & Sons A/S. |
Affiliation:
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Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. michael.agus@childrens.harvard.edu |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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