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Diabetes Mellitus Management 'PENTAD'-Reply
Claude K. Lardinois, MD
Reno, Nev
Arch Fam Med. 1994;3(11):944.
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In reply
I appreciate Lawler's concern about the routine use of hemoglobin A1c measurement as part of the evaluation for certain diabetic populations. Like Lawler, I have many patients who choose to maintain their glucose level between 13.9 and 16.6 mmol/L (250 and 300 mg/dL). Encouraging health care providers to do routine hemoglobin A1c measurements for this subset of noncompliant patients probably adds nothing to their management and should be discouraged. I have, however, successfully persuaded many noncompliant patients to change by employing the measurement of hemoglobin A1c. The hemoglobin A1c measurement provides the patient an "average" blood glucose value over the past 2 months. The test helps patients overcome the anxiety and frustration associated with the often wild swings in their day-to-day home glucose monitoring values, even during times of sincere effort to improve glycemic control. A hemoglobin A1c value of less than 125% of the
. . . [Full Text PDF of this Article]
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