Formula improves understanding of glucose
Researchers have found a mathematical relationship between two common blood glucose measurements that can help diabetics better monitor their condition.
An international study1 describes the ties discovered between the three-month average glucose reading and levels of the A1C test and converting it to estimated average glucose (eAG). Most home-monitoring systems used by diabetics measure eAG in one type of unit, while A1C, which doctors have used for more than 25 years as the major measure of glucose control, is in different units.
Because patients sometimes find it difficult to understand the concept of glycated hemoglobin, it will be much easier to have all test results, both those from the lab and those performed by the patient, in the same units. "The findings of this large study have confirmed what smaller studies have shown and will give us confidence that A1C really does represent an average glucose, because we now have a reliable formula to convert A1C into average glucose," said David M. Nathan, MD, professor of medicine, Harvard Medical School, and co-chair of the International A1C-Derived Average Glucose (ADAG) Study.
"We developed an equation that can be interpreted accurately as an estimated average glucose level by comparing the measurement of A1C with the average glucose levels," says study co-author Edward S. Horton, MD, a professor of medicine at Harvard Medical School.
There are some limits to the study that will require further investigation, points out Horton. Some ethnic-racial groups, notably those of African and Asian descent, were under-represented; children and pregnant women were not studied, and patients with unstable glucose level or possible red blood cell disorders were also not included.
Educating diabetics and doctors about the relationship and how to take advantage of it, though, will soon begin by the American Diabetes Association (ADA), European Association for the Study of Diabetes, and International Diabetes Federation. The ADA Web site, www.diabetes.org, is already letting doctors purchase an inexpensive hand-held calculator that will quickly convert A1C values to eAG.
Reference
1. Nathan DM, Kuenen J, Borg R, et al. Translating the A1C Assay Into Estimated Average Glucose Values. Diabetes Care 2008; 31:1473-1478.
Researchers have found a mathematical relationship between two common blood glucose measurements that can help diabetics better monitor their condition.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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