¿Es útil A1C para diagnóstico y seguimiento de diabetes mellitus tipo 2?

Authors

  • Ángela Luongo Pueyrredón Medical Offices, Banfield, Province of Buenos Aires, Argentina
  • Silvana Alejandra Milrad Manuel Rocca Hospital, Autonomous City of Buenos Aires, Argentina
  • Alicia Beatriz García Diabetology Service, Hospital Córdoba, Córdoba, Argentina
  • Eva López González University of Buenos Aires (UBA), National University of San Marti?n (UNSAM), Autonomous City of Buenos Aires, Argentina
  • María Ruiz Morosino Diabetology and Metabolic Diseases Clinic (CODIME), Autonomous City of Buenos Aires, Argentina
  • María Cristina Varela Central Hospital of San Isidro, Dr. Melchor Posse, Province of Buenos Aires
  • Bárbara Arinovich Nutrition and Diabetes Clinic, Autonomous City of Buenos Aires, Argentina
  • Claudio Daniel González Austral University and University of Buenos Aires, (UBA), Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v47i3.212

Keywords:

type 2 diabetes mellitus, hemoglobin a1c (a1c), diagnosis, follow-up

Abstract

Objectives: to assess the significance physicians give to glycosylated hemoglobin A1c (A1C) for diagnosis and follow-up in type 2 Diabetes patients and their values for diagnosis and therapeutical targets according to speciality. Material and Methods: observational, crosssectional study performed through surveys to physicians attending the Argentine Congress on Diabetes (2010). Specialties were: Nutrition, Diabetology, Endocrinology, Internal Medicine, General Medicine and other. Statistical analysis: descriptive statistics, Chi2 test, ANOVA (Student-Newman-Keuls post hoc). Software: Med-Calc 2009.Results: 743 surveys, mean age 43,3+10,4 years. 69,3% female. 32.9% of the surveyed physicians considered A1C non-beneficial for diagnostic purposes. The mean for diagnosis was 6,56 + 0,42% and 25% of the surveyed physicians considered A1C >7 as value for diagnosis. Physicians request A1C to 95,5% of patients, with differences between groups P<0,001. The frequency range for requesting A1C was every 3 months. 4,2% did not perform A1C dosages due to lack of access. The objective of the A1C for treatment was 6,7 ± 0,43%, with no differences per group p = 0,79. 72,5% showed having more flexibility in target value in elder people, CVD and risk of hypoglycemia. 87,9% considered the A1C useful to assess cardiovascular risk. Conclusions: 33% considered the A1C not appropriate for diagnosis. For those considering it useful, the cut-off value was approximately 6,5%. The target value for follow-up was close to 6,5% and flexible for elder people, CVD and risk of hypoglycemia. The test was considered beneficial for assessing cardiovascular risk.

Author Biographies

Ángela Luongo, Pueyrredón Medical Offices, Banfield, Province of Buenos Aires, Argentina

Nutrition Specialist

Silvana Alejandra Milrad, Manuel Rocca Hospital, Autonomous City of Buenos Aires, Argentina

Diabetologist

Alicia Beatriz García, Diabetology Service, Hospital Córdoba, Córdoba, Argentina

Staff Doctor, Diabetology Service

Eva López González, University of Buenos Aires (UBA), National University of San Marti?n (UNSAM), Autonomous City of Buenos Aires, Argentina

Specialist in Nutrition and Medical Clinic; Professor assigned to Nutrition, University of Buenos Aires (UBA); Director of the Diploma in Higher Studies in Diabetes National University of San Martín (UNSAM)

María Cristina Varela, Central Hospital of San Isidro, Dr. Melchor Posse, Province of Buenos Aires

Physician, Nutrition Specialist

Bárbara Arinovich, Nutrition and Diabetes Clinic, Autonomous City of Buenos Aires, Argentina

Medical specialist in internal medicine and nutrition

Claudio Daniel González, Austral University and University of Buenos Aires, (UBA), Autonomous City of Buenos Aires, Argentina

Pharmacologist doctor; Advisor on the methodology of the clinical and epidemiological evidence qualification processes

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Published

2023-01-10

How to Cite

Luongo, Ángela, Milrad, S. A., García, A. B., López González, E., Ruiz Morosino, M., Varela, M. C., Arinovich, B., & González, C. D. (2023). ¿Es útil A1C para diagnóstico y seguimiento de diabetes mellitus tipo 2?. Journal of the Argentine Society of Diabetes, 47(3), 81–86. https://doi.org/10.47196/diab.v47i3.212

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