Drug Topics - March 17, 2008 - (Page 7)

7 and mutually agreeing upon target-specific glycemic goals,” said Morello. The CEAS also recommends that the goal for hemoglobin A1c level should be based on individualized assessment of risk for complications from diabetes, comorbidity, life expectancy, and patient preferences. “For most people with Type 2 diabetes, the target HgA1c should be as close as possible to the normal without causing adverse events. While tighter control may be ideal for some patients, exceptions exist, particularly for patients with a high fall risk, a short life expectancy from comorbid conditions, or for patients of advanced age,” stated Morello. “For some patients making the correlation between HgA1c and their glucose meter reading might be confusing,” continued Morello. In the near future, average blood glucose levels—rather than HgA1c—might be used to assess long-term glycemic control. “I feel we should use whatever target goal is most user friendly and understandable to the patient. Using an average plasma glucose concentration would certainly meet this purpose since conceptually it relates more with the glucose values patients see on their glucose meters,” added Morello. David M. Nathan, M.D., professor at Harvard University Medical School in Boston and chief of the diabetes unit medical service and the diabetes center at Massachusetts General Hospital, is the lead investigator of the A1c-Derived Average Glucose Examination (ADAGE) study. The objective of the study was to establish a validated relationship between HgA1c and average blood glucose across diabetes types, a wide range of HbA1c levels and age, and different ethnicities. “With a confirmed mathematical relationship hemoglobin A1c could be reported as an estimated average glucose. The advantage of reporting HbA1c into an estimated average glucose would be using the same units as the patients’ self-monitoring of daily glycemia,” stated Judith Kuenen, M.D., at the 43rd Annual Meeting of the European Association for the Study of Diabetes, held last September. “No matter what measurement we use, the bottom line is that we want to help our patients better understand their diabetes and the effects that food, exercise, and medications have on their glucose concentrations and their overall long-term health,” concluded Morello. THE AUTHOR is a writer based in New Jersey. http://www.watson.com http://www.watson.com

Table of Contents Feed for the Digital Edition of Drug Topics - March 17, 2008

Drug Topics - March 17, 2008 Contents Commonly Confused Drug Pairs Medicaid Prescription Reimbursement Information By State ACP Issues Guidance On Optimal HbA1c for Type 2 Diabetics Latest News Roundup

Drug Topics - March 17, 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.