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Utility of immediate hemoglobin A1c in children with type I diabetes mellitus

Michael S D Agus1, Jamin L Alexander, Joseph I Wolfsdorf

  • 1Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. michael.agus@childrens.harvard.edu

Pediatric Diabetes
|January 15, 2010
PubMed

Insights

Immediate feedback of hemoglobin A1c (HbA1c) results in children with type 1 diabetes was more acceptable and less painful. While not sustaining glycemic control improvements alone, it enhanced patient-clinician communication.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management
  • Clinical Trials

Background:

  • Immediate feedback (IFB) of hemoglobin A1c (HbA1c) results can aid clinical decisions in adults with diabetes.
  • The impact of IFB on glycemic control and patient care in children with type 1 diabetes requires investigation.

Purpose of the Study:

  • To determine if IFB of HbA1c results in children with type 1 diabetes improves patient care and glycemic control.
  • To compare the acceptability and pain associated with IFB versus conventional HbA1c testing methods.

Main Methods:

  • A prospective randomized controlled trial involving children under 18 with type 1 diabetes.
  • Patients were randomized to receive IFB via point-of-care fingerstick testing or conventional venipuncture with delayed results.
  • HbA1c levels, therapy changes, and pain were recorded over one year.

Main Results:

  • IFB showed a significant improvement in HbA1c at 3 months, but this was not sustained.
  • Conventional feedback was associated with increased HbA1c at 12 months.
  • IFB was rated as significantly less painful and led to more efficient patient-clinician communication.

Conclusions:

  • Immediate feedback HbA1c testing is a more acceptable and less painful method for children with type 1 diabetes.
  • IFB alone did not result in sustained glycemic control improvements but positively impacted communication.
  • Further research may explore combined strategies for enhanced diabetes management in pediatric populations.
Abstract

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