A Retrospective Study in 5,989 Patients with Type 1 Diabetes in 10 Outpatient Diabetes Clinics in Sweden of the Frequency of Measuring HbA1c in Clinical PracticeViktorija Matuleviciene1,2, Stig Attvall2,3, Magnus Ekelund4, Mark Clements5, Sofia Dahlqvist1, Martin Fahlén6, Aldina Pivodic7, Börje Haraldsson8 and Marcus Lind1,2*
- *Corresponding Author:
- Marcus Lind
Department of Medicine NU-Hospital Organization and Department of Molecular and Clinical medicine University of Gothenburg
Gothenburg, 451 80 Uddevalla, Sweden
Received date: April 26, 2014; Accepted date: May 26, 2014; Published date: May 29, 2014
Citation: Matuleviciene V, Attvall S, Ekelund M, Clements M, Dahlqvist S, et al. (2014) A Retrospective Study in 5,989 Patients with Type 1 Diabetes in 10 Outpatient Diabetes Clinics in Sweden of the Frequency of Measuring HbA1c in Clinical Practice. J Diabetes Metab 5:377. doi: 10.4172/2155-6156.1000377
Copyright: © 2014 Matuleviciene V, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Aim: Guidelines for the treatment of type 1 diabetes generally recommend quarterly or more frequent Haemoglobin A1c (HbA1c) assessment in patients with inadequate glycaemic control. The purpose of the current study was to evaluate to what extent these guidelines are followed in clinical practice in Sweden.
Method: We studied 5989 patients with type 1 diabetes from 10 outpatient diabetes clinics in Sweden from 1 January 2005 to 31 December 2009. Data on HbA1c measurement frequency were obtained from the Diab-Base electronic medical records database, where HbA1c measurements are recorded together with other patient characteristics, including treatment and other general risk factors for diabetic complications. The frequency of HbA1c measurements was obtained for all patients by calendar year, care unit, and during time periods where glucose was classified as well controlled (HbA1c<=7.0%) or inadequate (HbA1c 7.0% or higher).
Results: The mean annual number of HbA1c assessments when glucose control was inadequate was 1.83 compared with 1.58 during well controlled time-periods. In 35.4% of cases the next HbA1c check following an HbA1c >7% was performed within 4 months. The probability of a subsequent assessment in the 4 months following an HbA1c value>7.0% increase in patients treated with continuous subcutaneous insulin infusion (CSII), OR=1.57 (1.46-1.69). Differences were also noted by care unit, age, gender, glycaemic control, calendar year, and weight and diabetes duration.
Conclusion: In patients with type 1 diabetes, HbA1c is measured less frequently in clinical practice in Sweden than guidelines recommend, although patients with CSII and treated in certain care units receive more frequent assessments.